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Objective To compare the clinical efficacy of natural orifice specimen extraction surgery(NOSES)combined with enhanced recovery after surgery(ERAS)and conventional laparoscopic surgery in treatment of rectal cancer patients.Methods A hundred patients with rectal cancer in the Department of Colorectal and Anal Surgery,the 940th Hospital of Joint Logistics Support Force of PLA were selected as the research objects from January 2019 to December 2021,including 49 cases treated with NOSES combined with ERAS were set as the observation group,and 51 cases treated with conventional laparoscopic surgery of rectal cancer were set as the control group.Postoperative C-reactive protein(CRP),procalcitonin(PCT),interleukin-6(IL-6),white blood cell count(WBC),percentage of neutrophil(NEUT),K+ concentration,postoperative peristalsis recovery time,first time out-of-bed activity,first liquid feeding time,removal time of urinary,and drainage tubes,hospital stay and intraoperative blood loss,number of lymph node detection,positive margin rate,incidence of complications,and pain score were compared between the two groups.Results The observation group showed significant lower postoperative CRP,PCT,IL-6 levels when compared with control group(P<0.05),while no significant difference in K+ concentration between the two groups(P>0.05).The recovery time of intestinal peristalsis,the time of the first out-of-bed activity,the first liquid feeding time,the time of removal of the urinary tube and the drainage tube,and the number of days of hospitalization in observation group were all superior to the control group(P<0.05).The observation group with the duration of surgery was longer than the control group,and the difference was statistically significant(P<0.05).There were no significant differences in intraoperative bleeding,number of lymph nodes detected and positive rate of resection margins between the two groups(P>0.05).There was no significant difference in the incidence of complications between the two groups(4.1%vs.7.8%,P>0.05).The observation group showed significant lower pain scores than control group on the 1st,2nd and 3rd day after surgery(P<0.05).Conclusions NOSES combined with ERAS in treatment of rectal cancer patients is safe and feasible,can narrow the surgical incision,alleviate stress response and postoperative pain,improve postoperative efficacy and reduce the occurrence of complications,so is worthy of promotion and application.
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Objective To investigate the infection status and changing trend of hepatitis C virus(HCV)infection in hospitalized patients in medical institutions,and provide reference for formulating HCV infection prevention and control strategies.Methods HCV infection surveillance results from cross-sectional survey data reported to China Healthcare-associated Infection(HAI)Surveillance System in 2020 were summarized and analyzed,HCV positive was serum anti-HCV positive or HCV RNA positive,survey result was compared with the survey results from 2003.Results In 2020,1 071 368 inpatients in 1 573 hospitals were surveyed,738 535 of whom underwent HCV test,4 014 patients were infected with HCV,with a detection rate of 68.93%and a HCV positive rate of 0.54%.The positive rate of HCV in male and female patients were 0.60%and 0.48%,respectively,with a statistically sig-nificant difference(x2=47.18,P<0.001).The HCV positive rate in the 50-<60 age group was the highest(0.76%),followed by the 40-<50 age group(0.71%).Difference among all age groups was statistically signifi-cant(x2=696.74,P<0.001).In 2003,91 113 inpatients were surveyed.35 145 of whom underwent HCV test,resulting in a detection rate of 38.57%;775 patients were infected with HCV,with a positive rate of 2.21%.In 2020,HCV positive rates in hospitals of different scales were 0.46%-0.63%,with the highest in hospital with bed numbers ranging 600-899.Patients'HCV positive rates in hospitals of different scales was statistically signifi-cant(X2=35.34,P<0.001).In 2020,12 provinces/municipalities had over 10 000 patients underwent HCV-rela-ted test,and HCV positive rates ranged 0.19%-0.81%,with the highest rate from Hainan Province.HCV posi-tive rates in different departments were 0.06%-0.82%,with the lowest positive rate in the department of pedia-trics and the highest in the department of internal medicine.In 2003 and 2020,HCV positive rates in the depart-ment of infectious diseases were the highest,being 7.95%and 3.48%,respectively.Followed by departments of orthopedics(7.72%),gastroenterology(3.77%),nephrology(3.57%)and general intensive care unit(ICU,3.10%)in 2003,as well as departments of gastroenterology(1.35%),nephrology(1.18%),endocrinology(0.91%),and general intensive care unit(ICU,0.79%)in 2020.Conclusion Compared with 2003,HCV positive rate decreased significantly in 2020.HCV infected patients were mainly from the department of infectious diseases,followed by departments of gastroenterology,nephrology and general ICU.HCV infection positive rate varies with gender,age,and region.
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Diabetic kidney disease (DKD) is the primary cause of mortality among diabetic patients. With the increasing prevalence of diabetes, it has become a major concern around the world. The therapeutic effect of clinical use of drugs is far from expected, and therapy choices to slow the progression of DKD remain restricted. Therefore, research on new drugs and treatments for DKD has been a hot topic in the medical field. It has been found that rhein has the potential to target the pathogenesis of DKD and has a wide range of pharmacological effects on DKD, such as anti-nephritis, decreasing blood glucose, controlling blood lipids and renal protection. In recent years, the medical value of rhein in the treatment of diabetes, DKD and renal disease has gradually attracted worldwide attention, especially its potential in the treatment of DKD. Currently, DKD can only be treated with medications from a single symptom and are accompanied by adverse effects, while rhein improves DKD with a multi-pathway and multi-target approach. Therefore, this paper reviews the therapeutic effects of rhein on DKD, and proposes solutions to the limitations of rhein itself, in order to provide valuable references for the clinical application of rhein in DKD and the development of new drugs.
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Humans , Diabetic Nephropathies/drug therapy , Kidney/pathology , Anthraquinones/therapeutic use , Diabetes MellitusABSTRACT
Objective To understand the distribution and antimicrobial resistance changes of bacteria isolated from pleural and peritoneal effusion in Hunan Province,and provide reference for correct clinical diagnosis and rational antimicrobial use.Methods Data reported by member units of Hunan Provincial Antimicrobial Resistance Survei-llance System from 2012 to 2021 were collected.Bacteria antimicrobial resistance surveillance method was imple-mented according to technical scheme of China Antimicrobial Resistance Surveillance System(CARSS),and WHO-NET 5.6 software was used to analyze the data of bacteria isolated from pleural and peritoneal effusion as well as antimicrobial susceptibility testing results.Results From 2012 to 2021,a total of 28 934 bacterial strains were iso-lated from specimens of pleural and peritoneal effusions from member units of Hunan Provincial Antimicrobial Re-sistance Surveillance System,with 5 752 strains from pleural effusion and 23 182 from peritoneal effusion.The top five bacteria isolated from pleural effusion were Escherichia coli(n=907,15.8%),Staphylococcus aureus(n=535,9.3%),Klebsiella pneumoniae(n=369,6.4%),Staphylococcus epidermidis(n=452,7.9%),and Staphy-lococcus haemolyticus(n=285,5.0%).The detection rate of methicillin-resistant Staphylococcus aureus(MR-SA)from pleural effusion was 24.3%-39.2%,and that of methicillin-resistant coagulase negative Staphylococcus(MRCNS)was 58.8%-77.1%.The top five bacteria isolated from peritoneal effusion were Escherichia coli(n=8 264,35.6%),Klebsiella pneumoniae(n=2 074,9.0%),Enterococcus faecium(n=1 458,6.3%),Staphylo-coccus epidermidis(n=1 383,6.0%),and Pseudomonas aeruginosa(n=1 152,5.0%).The detection rate of MRSA from peritoneal effusion was 22.1%-52.4%,which presented a decreasing trend(P=0.004).The detec-tion rate of MRCNS was 60.4%-79.4%.The resistance rates of Enterobacterales from peritoneal effusion to ce-fazolin,cefuroxime,ceftriaxone and cefepime all showed decreasing trends(all P<0.05).Vancomycin-,linezo-lid-,and teicoplanin-resistant Staphylococcus strains were not found in pleural and peritoneal effusions.The resis-tance rates of Enterococcus faecium to most tested antimicrobial agents were higher than those of Enterococcus fae-calis.The resistance rates of Enterobacterales to imipenem and meropenem were ≤8.5%.The resistance rates of non-fermentative Gram-negative bacilli to imipenem and meropenem were ≤43.3%.Conclusion The data structure of Hunan Antimicrobial Resistance Surveillance System for pleural and peritoneal effusions from 2012 to 2021 is relatively complete.The constituent and antimicrobial susceptibility of isolated pathogenic bacteria vary in different years.
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In order to establish a real-time RT-PCR based on SYBR Green Ⅱ for detection of hepatitis E virus (HEV),a pair of special primers was designed according to the conserved sequences of ORF2 in GenBank.Result showed that the standard curve of established SYBR Green Ⅱ real-time RT-PCR had a wide dynamic range from 4.10 × 102-4.10 × 108 copies/μL with a linear correlation(r2) of 0.996.The sensitivity could reach 1.00 × 102 copies/μL.The melting curve analysis using SYBR Green Ⅱ dye showed one specific peak with a melting temperature(Tm) of 84.0 C ±0.1 C.No amplification was detected from the RNA samples of porcine reproductive and respiratory syndrome virus,classial swine fever virus,transmissible gastroenteritis virus,porcine bocavirus,porcine epidemic dearrhoea virus porcine kobuvirus and porcine rotavirus by this PCR,respectively.Excellent reproducibility was obtained for detecting constructed positive plasmid DNA with intra-assay of 0.83 %-0.94 % and inter-assay of 0.83%-0.94%.Further detection of 61 specimens showed that 9 of them were HEV positive,and the results of the quantitative RT-PCR were the same as that of the conventional RT-PCR.In conclusion,the real-time quantitative RT-PCR for HEV is feasible,the real-time RT-PCR established in this study will be useful for earlier rapid laboratory diagnosis and pathogenesis of HEV.
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<p><b>OBJECTIVE</b>To investigate the antibiotics use in inpatients with hospitals under different scales.</p><p><b>METHODS</b>On the day of August 7, 2003, antibiotics use among inpatients were investigated, medical order to each inpatient was checked and forms were filled.</p><p><b>RESULTS</b>Data showed that 54.86% of the 89,539 inpatients from 151 hospitals were using antibiotics, out of which 48.98% were used for therapeutic purposes while 35.44% for prophylaxis, and 15.58% for both therapy and prophylaxis. Among those who had received antibiotics, 61.43% received one, 33.65% received two and 4.92% received 3 or more agents. In patients who were on antibiotics for therapy, only 23.92% of the samples were sent for pathogens detection. The prevalence of antibiotics use was different among different hospitals, with teaching hospitals having the lowest and hospitals with less than 300 beds were higher than those with more than 300 beds. Departments of respiratory diseases, intensive care unit, and pediatrics had the higher use of antibiotics.</p><p><b>CONCLUSION</b>Inpatients in 151 hospitals had high prevalence of antibiotics use, especially for prophylaxis use but pathogen detection was seldomly done. It is necessary to strengthen the rational use and management of antibiotics use in the hospitals.</p>
Subject(s)
Female , Humans , Male , Anti-Bacterial Agents , Therapeutic Uses , Antibiotic Prophylaxis , China , Costs and Cost Analysis , Data Collection , Drug Utilization Review , Inpatients , Surveys and QuestionnairesABSTRACT
Objective:To investigate the feasibility of using marrow stromal cells (MSC) as seed cells and three-dimensional porous nano-hydroxylapatite as scaffolds for constructing tissue-engineered bone.Methods:MSC from rat were cultured and induced to differentiate into osteoblasts in vitro. And then these induced cells were identified and seeded onto three-dimensional porous nano-hydroxylapatite scaffolds, cultured for 15 days in vitro. Scanning electron microscopy was used to evaluate the growth of these induced cells on three-dimensional porous nano-hydroxylapatite scaffolds. Results: The activity of alkaline phosphatase (ALP) and the secretion of osteocalcin of MSC from rat appeared and were increased gradually along the culture. The cells seeded on three-dimensional porous nano-hydroxylapatite scaffolds could adhere and proliferate well, and come into being many tiny calcium nodules and collagenous fibers. Conclusion:The data demonstrated that the new developed culture method is conducive to MSC’s differentiating and proliferating into osteoblasts that have a fine activity and the three-dimensional porous nano-hydroxylapatite may be considered as a suitable scaffold for the seeded cells. Using marrow stromal cells as seed cells and three-dimensional porous nano-hydroxylapatite as scaffolds is advantageous for constructing tissue-engineered bone.
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Objective:Because of the lower proliferation ability of periodontal ligament cells of elderly people,how to choose suitable scaffold materials for them becomes very important.The aim of this study was to observe the morphological manifestation of the periodontal ligament cells of elderly people seeded onto the three-dimensional porous nano-hydroxylapatite scaffolds.Methods: Periodontal ligament cells from elderly people were seeded onto the three-dimensional porous nano-hydroxylapatite scaffolds,cultured for 15 days in vitro,and observed for the morphological changes by scanning electron microscopy in comparison with those of young people.Results:Fifteen days after seeded on the three-dimensional porous nano-hydroxylapatite scaffolds,the periodontal ligament cells of the elderly people exhibited sufficient adhesive behavior,proliferated well and produced tiny calcium nodules,but the number of the nodules was smaller than that in the young people.Conclusion: The periodontal ligament cells of elderly people grow well on three-dimensional porous nano-hydroxylapatite scaffolds,and can be considered as a suitable scaffold for periodontal tissue engineering in elderly people.
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Objective The purpose of this study was to develop a new cultural method, so that the rat bone marrow stromal cells (MSCs) can well differentiate into osteoblasts in vitro and the cultured osteoblasts can be identified. Methods MSCs of rats were isolated and cultured, then the cultured cells were identified with inverted microscopy and undergone an HE stain for observing the morphology of living cells, and the cells were histochemically stained for examining the activity of cellular alkaline phosphatase (ALP), as well as were radio-immunologically analyzed for detecting the secretion of osteocalcin. Results The MSCs were typical fibroblast-like and possess a strang proliferative capability after cultured in vitro.The cellular ALP activity and osteocalcin secretion achieved the peak value from the fortieth day and maintained the status until the sixtieth day after cultured in vitro.Conclusion The data demonstrated that the new developed culture method has the advantages of short time, less risk of contamination and higher efficiency, and conducive to MSC's differentiating and proliferating into osteoblasts that do function well.
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Objective To evaluate X-ray,CT and MRI findings of soft tissue infections in AIDS. Methods Three cases of soft tissue infections with AIDS were retrospectively analyzed by comparing the imaging findings with pathological results.All patients were performed MRI,X-ray was in 1 case,CT was in 1 case.Results Cellulitis was in 1 case:MRI showed extended thickening of subcutaneous tissues, ill-defined hypointense areas on T_1WI and hyperintensity on T_2WI,and reticular pattern on GRE. Necrotizing fasciitis was in 1 case:MRI showed obvious thickening of subcutaneous tissues and deep fasciae, abnormally increased signal intensity on T_1 and T_2WI.Fluid collections were within muscles and muscles interval on fat-suppressed T2 WI.Tuberculosis was in 1 case:CT demonstrated multiple low density areas in the subcutaneous tissues and clear peripheral rim enhancement.MRI appeared hypointense on T_1WI and hyperintensity on T_2WI,and peripheral rim enhancement following gadolinium injection.Conclusion Infections of soft tissue are common complication in patients with AIDS,radiology is important in early diagnosis and treatment planning in this population.
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Objective To observe effects of chitosan on proliferation and differentiation of human periodontal ligament cells( PDLC). Methods The human periodontal ligament cells were isolated and cultured.The effects of chitosan on proliferative ability of human PDLCs were evaluated with MTT method, and alkaline phosphatase activity and the secretion of osteocalcin of human PDLCs were measured with spectrophotometric assay and radioimmunological method. Results Compared with control group, the proliferative ability of human PDLCs in Chi(0.05g?L~ -1) group and Chi(0.1g?L~ -1) group at 3,5,7 day was considerably increased (P