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OBJECTIVE@#To compare the clinical efficacy and possible mechanism of warming acupuncture combined with "three steps and seven methods" of tuina and simple "three steps and seven methods" of tuina in treatment of chronic nonspecific low back pain (NLBP) of yang deficiency and cold-dampness blockage.@*METHODS@#A total of 138 patients were randomized into an observation group (69 cases, 5 cases dropped off) and a control group (69 cases, 7 cases dropped off). In the control group, "three steps and seven methods" of tuina was applied. On the basis of the treatment in the control group, warming acupuncture was applied at Shenshu (BL 23), Yaoyangguan (GV 3), Mingmen (GV 4), Weizhong (BL 40) and ashi points. The treatment was given once a day, 6 times a week for 3 weeks in both groups. Before and after treatment, the short form of McGill pain questionnaire (SF-MPQ) score, Oswestry disability index (ODI) score, finger-to-floor distance (FFD), Schober test distance, fear-avoidance beliefs questionnaire (FABQ) score and yang deficiency and cold-dampness blockage score were observed, the serum levels of tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, IL-6 and thromboxane B2 (TXB2) were detected in both groups. The recurrence rate was evaluated in follow-up of 6 months after treatment.@*RESULTS@#After treatment, the scores of PRI, PPI, VAS, ODI, FABQ and FFD, yang deficiency and cold-dampness blockage scores were decreased compared before treatment in both groups (P<0.01), and those in the observation group were lower than the control group (P<0.01); the Schober test distances were increased compared before treatment in both groups (P<0.01), and that in the observation group was larger than the control group (P<0.01). After treatment, the serum levels of TNF-α, IL-1β, IL-6 and TXB2 were decreased compared before treatment in both groups (P<0.01), and those in the observation group were lower than the control group (P<0.01). In follow-up, the recurrence rate was 12.8% (6/47) in the observation group, which was lower than 34.3% (12/35) in the control group (P<0.05).@*CONCLUSION@#Warming acupuncture combined with "three steps and seven methods" of tuina can effectively alleviate pain in patients with chronic NLBP of yang deficiency and cold-dampness blockage, improve activity and dysfunction of waist, the clinical efficacy is superior to simple "three steps and seven methods" of tuina, its mechanism may be relate to the inhibition of inflammatory reaction.
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Humanos , Pontos de Acupuntura , Terapia por Acupuntura , Interleucina-6 , Dor Lombar/terapia , Resultado do Tratamento , Fator de Necrose Tumoral alfa , Deficiência da Energia Yang/terapiaRESUMO
Objective: To provide an objective cost–utility evaluation of a colorectal cancer screening program in a hypothetical general population. Materials and Methods: A cost–utility analysis was conducted comparing screened individuals with the general population. Patients were evaluated as part of the screening program which conducted colorectal cancer risk assessments and performed colonoscopies from October 2012 to May 2013. Data were compared to a hypothetical group of the same size, consisting of the general population in which no cancer screening had been conducted. The cost and utility data have been published previously. Results: The average cost per quality-adjusted life year (QALY) of colorectal cancer screening population was 84,092 CNY, while the average cost per QALY of the general population was 122,530 CNY. The colorectal cancer screening program saved 43,530 CNY per additional QALY. Conclusion: The colorectal cancer screening program could improve health-related quality of life and reduce medical expenditure
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Objective:To observe the clinical efficacy Guilu Bugu prescription in treating postmenopausal osteoporosis (PMO) with deficiency of liver and kidney Yin based on syndrome differentiation and the effect on Th17/Treg cell factors. Method:One hundred and forty patients were randomly divided into observation group (70 cases) and control group (70 cases) by random number table. Both groups' patients got basic treatment of western medicine. Patients in control group got Jintiange capsules, 3 grains/time, 3 times/day. Patients in observation group got Guilu Bugu prescription, 1 dose/day. The treatment lasted for 6 months. And the 6-month follow-up was recorded. Before treatment, at the 6th month after treatment and at the 6th month of follow-up, bone density of lumbar vertebra L2-4 were detected by DXA, and Lumbar BMD were detected by QCT. Before treatment, at the 3rd and 6th month after treatment, deficiency of liver and kidney Yin and Chinese Osteoporosis-targeted quality of life questionnaire (COQOL) were scored. Before and after treatment, Estradiol (E2), procollagen I amino terminal pro peptide (PINP), osteoprotegerin (OPG), collagen I cross linked C-terminal peptide (S-CTX), tartrate resistant acid phosphatase (TRACP), interleukin-17 (IL-17), IL-22, IL-10, transforming growth factor-β1 (TGF-β1) were detected, and CD4+ cells, Th17 cells and Treg cells were calculated. And the safety was evaluated. Result:At the 6th month after treatment and the 6th month of follow-up, DXA (bone mineral density and T-value of lumbar L2-4) and QCT bone mineral density increased (P<0.01), and the figures in observation group were all higher than those in control group (P<0.01). At the 3rd and 6th month after treatment, scores of deficiency of liver and kidney Yin and quality of life were all lower than those in control group (P<0.01). Levels of PINP, S-CTX, TRACP, Th17 cells, ratio of Th17 and Treg, IL-17 and IL-22 were all lower than those in control group (P<0.01), and levels of OPG, E2, Treg, IL-10 and TGF-β1 were all higher than those in control group (P<0.01).There was no adverse reaction related to Guilu Bugu prescription. Conclusion:Based on the supplementation of calcium and vitamin D, Guilu Bugu prescription can further improve the bone mineral density, raise the estrogen level, regulate the expressions of bone metabolism markers, Th17, Treg and relevant factors, reverse the imbalance of Th17/Treg, relieve the clinical symptoms and improve the quality of life, with a better efficacy than that of Jintange capsule and a high safety.
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Naodesheng (NDS) formula, which consists of Rhizoma Chuanxiong, Lobed Kudzuvine, Carthamus tinctorius, Radix Notoginseng, and Crataegus pinnatifida, is widely applied for the treatment of cardio/cerebrovascular ischemic diseases, ischemic stroke, and sequelae of cerebral hemorrhage, etc. At present, the studies on NDS formula for Alzheimer's disease (AD) only focus on single component of this prescription, and there is no report about the synergistic mechanism of the constituents in NDS formula for the potential treatment of dementia. Therefore, the present study aimed to predict the potential targets and uncover the mechanisms of NDS formula for the treatment of AD. Firstly, we collected the constituents in NDS formula and key targets toward AD. Then, drug-likeness, oral bioavailability, and blood-brain barrier permeability were evaluated to find drug-like and lead-like constituents for treatment of central nervous system diseases. By combining the advantages of machine learning, molecular docking, and pharmacophore mapping, we attempted to predict the targets of constituents and find potential multi-target compounds from NDS formula. Finally, we built constituent-target network, constituent-target-target network and target-biological pathway network to study the network pharmacology of the constituents in NDS formula. To the best of our knowledge, this represented the first to study the mechanism of NDS formula for potential efficacy for AD treatment by means of the virtual screening and network pharmacology methods.
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Humanos , Doença de Alzheimer , Tratamento Farmacológico , Patologia , Autoanálise , Disponibilidade Biológica , Biomarcadores , Biomarcadores Farmacológicos , Bases de Dados de Compostos Químicos , Combinação de Medicamentos , Descoberta de Drogas , Métodos , Medicamentos de Ervas Chinesas , Química , Farmacologia , Usos Terapêuticos , Aprendizado de Máquina , Simulação de Acoplamento Molecular , Redes Neurais de Computação , Fragmentos de Peptídeos , Química , PermeabilidadeRESUMO
Naodesheng (NDS) formula, which consists of Rhizoma Chuanxiong, Lobed Kudzuvine, Carthamus tinctorius, Radix Notoginseng, and Crataegus pinnatifida, is widely applied for the treatment of cardio/cerebrovascular ischemic diseases, ischemic stroke, and sequelae of cerebral hemorrhage, etc. At present, the studies on NDS formula for Alzheimer's disease (AD) only focus on single component of this prescription, and there is no report about the synergistic mechanism of the constituents in NDS formula for the potential treatment of dementia. Therefore, the present study aimed to predict the potential targets and uncover the mechanisms of NDS formula for the treatment of AD. Firstly, we collected the constituents in NDS formula and key targets toward AD. Then, drug-likeness, oral bioavailability, and blood-brain barrier permeability were evaluated to find drug-like and lead-like constituents for treatment of central nervous system diseases. By combining the advantages of machine learning, molecular docking, and pharmacophore mapping, we attempted to predict the targets of constituents and find potential multi-target compounds from NDS formula. Finally, we built constituent-target network, constituent-target-target network and target-biological pathway network to study the network pharmacology of the constituents in NDS formula. To the best of our knowledge, this represented the first to study the mechanism of NDS formula for potential efficacy for AD treatment by means of the virtual screening and network pharmacology methods.
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Humanos , Doença de Alzheimer , Tratamento Farmacológico , Patologia , Autoanálise , Disponibilidade Biológica , Biomarcadores , Biomarcadores Farmacológicos , Bases de Dados de Compostos Químicos , Combinação de Medicamentos , Descoberta de Drogas , Métodos , Medicamentos de Ervas Chinesas , Química , Farmacologia , Usos Terapêuticos , Aprendizado de Máquina , Simulação de Acoplamento Molecular , Redes Neurais de Computação , Fragmentos de Peptídeos , Química , PermeabilidadeRESUMO
Aim To observe whether matrix metallo-proteinase-14 ( MMP-14) and tissue matrix metallopro-teinase inhibitor-4 ( TIMP-4) were involved in the car-diac-protection of mitochondrial aldehyde dehydrogen-ase 2 ( ALDH2) against high glucose induced rat pri-mary cardiomyocyte injury. Methods Rat primary cardiomyocytes were cultured. The cardiomyocyte via-bility was detected by MTT assay at different concentra-tion of glucose at different time point. After established high glucose-induced cardiomyocytes injury model, cardiomyocytes were randomly divided into 4 groups:normal control group ( NG, glucose at 5.5 mmol· L-1) , NG + Alda-1 group ( Alda-1 at 20 μmol·L-1) , high glucose group ( HG, glucose at 30 mmol·L-1) and HG+Alda-1 group. The cell viability at 48 h and oxidative stress level were detected by MTT and DHE staining methods. The protein expressions of ALDH2, MMP-14 and TIMP-4 were determined by Western blot. Results The cardiomyocytes injury model was established according to the cell activity result. Com-pared with NG group, the cell viability, the protein ex-pressions of ALDH2, MMP-14, the ratio of MMP-14/TIMP-4 were decreased, TIMP-4 protein expression and the level of oxidative stress were increased in HG group. Compared with HG group, in HG + Alda-1 group, the cell viability, the protein expressions of AL-DH2, MMP-14, the ratio of MMP-14/TIMP-4 were in-creased, the levels of oxidative stress and TIMP-4 pro-tein expression were decreased. Conclusion Activa-tion of mitochondrial ALDH2 may relieve high glucose induced cardiomyocytes injury. The protective effect was likely related to the inhibition of oxidative damage, down-regulation of MMP-14 and up-regulation of TIMP-4 proteins.
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This study aims to investigate the network pharmacology of Chinese medicinal formulae for treatment of Alzheimer's disease. Machine learning algorithms were applied to construct classifiers in predicting the active molecules against 25 key targets toward Alzheimer's disease (AD). By extensive data profiling, we compiled 13 classical traditional Chinese medicine (TCM) formulas with clinical efficacy for AD. There were 7 Chinese herbs with a frequency of 5 or higher in our study. Based on the predicted results, we built constituent-target, and further construct target-target interaction network by STRING (Search Tool for the Retrieval of Interacting Genes/Proteins) and target-disease network by DAVID (Database for Annotation, Visualization and Integrated Discovery) and gene disease database to study the synergistic mechanism of the herbal constituents in the Chinese traditional patent medicine. By prediction of blood-brain penetration and validation by TCMsp (traditional Chinese medicine systems pharmacology) and Drugbank, we found 7 typical multi-target constituents which have diverse structure. The mechanism uncovered by this study may offer a deep insight into the action mechanism of TCMs for AD. The predicted inhibitors for the AD-related targets may provide a good source of new lead constituents against AD.
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<p><b>OBJECTIVE</b>To explore the effects of pre-acupuncture and immediate acupuncture on kidney function and oxygen free radical metabolism in rats with simulated weightlessness.</p><p><b>METHODS</b>Twenty male clean-grade Wister rats were randomly divided into a normal control group, a model group, a pre-acupuncture group and an immediate acupuncture group, 5 rats in each one. The rats in the normal control group did not receive any treatment but free activities for 4 weeks. The rats in the rest groups received 4-week tail suspension to establish the model of simulated weightlessness. One week before the tail suspension, the rats in the pre-acupuncture group were treated with electroacupuncture at "Shenshu" (BL 23), "Pishu" (BL 20) and "Sanyinjiao" (SP 6) for 30 min per treatment, once a day for 7 days. The rats in the immediate acupuncture group received tail suspension and acupuncture at the same time; during the tail suspension, the electroacupuncture was applied at "Shenshu" (BL 23), "Pishu" (BL 20) and "Sanyinjiao" (SP 6) for 30 min per treatment, once every other day for 14 days. The colorimetric method was used to measure the content of blood urea nitrogen (BUN) in serum as well as activity of superoxide dismutase (SOD) and glutathione peroxidase (GSH-PX) and content of malonaldehyde (MDA) in renal tissue in each group.</p><p><b>RESULTS</b>Compared with the normal control group, the content of BUN in the model group was increased significantly (P<0.01), the activity of SOD and GSH-PX in nephridial tissue was significantly reduced (both P<0.01), and the content of MDA was increased significantly (P<0.05). Compared with the model group, the content of BUN in the pre-acupuncture group and immediate acupuncture group was significantly reduced (P<0.01, P<0.05), the activity of GSH-PX in the pre-acupuncture group was obviously increased (P<0.05) and the content of MDA in the immediate acupuncture group was increased significantly (P<0.01). Compared with the immediate acupuncture group, the content of MDA in the pre-acupuncture group was lower (P<0.01).</p><p><b>CONCLUSION</b>The pre-acupuncture and immediate acupuncture both have the capacity to improve the kidney function and anti-oxygen free radical injury in rats with simulated weightlessness, however, the capacity to increase the protection ability of the kidney and eliminate free radical in the pre-acupuncture group is superior to that in the immediate acupuncture group, which is likely to be related with improving antioxidant ability of kidney.</p>
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Animais , Humanos , Masculino , Ratos , Pontos de Acupuntura , Terapia por Acupuntura , Antioxidantes , Metabolismo , Rim , Metabolismo , Nefropatias , Metabolismo , Terapêutica , Malondialdeído , Metabolismo , Ratos Wistar , Espécies Reativas de Oxigênio , Metabolismo , Voo Espacial , Superóxido Dismutase , Metabolismo , Ausência de PesoRESUMO
This study is aimed to investigate the effects of high intracellular Mg²⁺ on L-type calcium channel in guinea-pig ventricular myocytes. The cardiomyocytes were acutely isolated with enzyme digestion method. By adopting inside-out configuration of patch clamp technique, single channel currents of the L-type calcium channel were recorded under different intracellular Mg²⁺ concentrations ([Mg²⁺]i). In control group, which was treated with 0.9 mmol/L Mg²⁺, the relative activity of calcium channel was (176.5 ± 34.1)% (n = 7). When [Mg²⁺]i was increased from 0.9 to 8.1 mmol/L (high Mg²⁺ group), the relative activities of calcium channel decreased to (64.8 ± 18.1)% (n = 6, P < 0.05). Moreover, under 8.1 mmol/L Mg²⁺, the mean open time of calcium channel was shortened to about 25% of that under control condition (P < 0.05), but the mean close time of calcium channel was not altered. These results suggest that high intracellular Mg²⁺ may inhibit the activities of L-type calcium channel, which is mainly due to the shortening of the mean open time of single L-type calcium channel.
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Animais , Canais de Cálcio Tipo L , Fisiologia , Cobaias , Magnésio , Fisiologia , Miócitos Cardíacos , Fisiologia , Técnicas de Patch-ClampRESUMO
The chemical constituents from the fruiting bodies of Lyophyllum decastes (Fr.) Singer were studied in this paper. Thirteen compounds were isolated and purified by column chromatographies on silica gel and Sephadex LH-20. Their structures were identified by MS and NMR data analysis as adenosine (1), 2R, 3S, 4S, 8E)-2-[(2'R)-2-hydroxyheneicosanoylamino]-8-octadecene-1, 3, 4-triol (2), (2R, 3S, 4S, 8E)-2-[(2'R)-2-hydroxypentacosanoylamino]-8-octadecene-1, 3, 4-triol (3), nicotinic acid (4), (4E, 8E) -2-N-2-hydroxytetracosanoyl-1-O-beta-D-glycopyranosyl-9-methyl-4, 8-sphingadienine (5), D-mannitol (6), ergosteryl-3-O-beta-D-glucopyranoside (7), tuberoside (8), (2R, 3S, 4S, 8E)-2-[(2'R)-2-hydroxybehenoylamino]-8-octadecene-1, 3, 4-triol (9),(2R, 3S, 4S, 8E)-2-[(2'R) -2-hydroxytricosanoylamino] -8-octadecene-1, 3, 4-triol (10), (22E, 24R)-ergosta-7, 22-dien-3beta, 5alpha, 6beta-triol (11), (22E, 24R)-ergosta-5, 7, 22-trien-3beta-ol (12), and 5alpha, 8alpha-epidiory-(22E, 24R)-ergosta-6, 22-dien-3beta-ol (13), respectively. All the above compounds are first obtained from the mushroom and compounds 2-10 are reported to be obtained from the Lyophyllum for the first time.
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Agaricales , Química , Medicamentos de Ervas Chinesas , Química , Frutas , QuímicaRESUMO
<p><b>OBJECTIVE</b>To compare the regulatory effects of electro-acupuncture (EA) at acupoints Zusanli (ST36) and Hegu (LI4) on the visceral hyper-sensitivity in the rat model of irritable bowel syndrome (IBS), and to explore the acting targets and specialty of acupoints.</p><p><b>METHODS</b>Except 8 rats of the normal control group, the rest 32 rats were prepared to set up the IBS models. IBS animal model was prepared by enema with acetic acid. Model rats were divided into three groups. Except for rats in the model group for control, those in the other two groups were treated 20 min by EA on ST36 (EA-ST36) and LI4 (EA-LI4) respectively for 2 weeks to observe the effect on behavior response of viscera sensitivity. The changes of neuropeptide (NPY), the somatostatin (SS) levels in blood and tissues of brain and intestine were monitored as well.</p><p><b>RESULTS</b>The volume thresholds for abdomen uplifting and back hunching were obviously increased after EA-ST36 (P<0.05), but showed insignificant change after EA-LI4. NPY contents lowered and SS contents increased in model rats; both EA-ST36 and EA-LI4 could raise the level of thalamic NPY (P<0.01 and P<0.05, respectively), but showed insignificant effects on NPY in colonic tissue. As for SS content, its colonic level could be reduced by EA-S36 and EA-LI4 (P<0.01 and P<0.05, respectively), however, its blood level was affected only by EA-ST36 (P<0.05).</p><p><b>CONCLUSIONS</b>EA-ST36 or EA-LI4 could regulate the NPY in thalamus and SS in colonic tissue, the former could affect blood level of SS as well. It is deemed that NPY and SS may be the key substances for regulating the action of acupuncture in the brain-intestinal axis; their different levels could be regarded as an indicator for the functional difference between the acupoints.</p>
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Animais , Ratos , Pontos de Acupuntura , Encéfalo , Metabolismo , Eletroacupuntura , Métodos , Síndrome do Intestino Irritável , Metabolismo , Neuropeptídeo Y , Metabolismo , Ratos Wistar , Somatostatina , Metabolismo , VíscerasRESUMO
<p><b>BACKGROUND</b>With a trend that renal tumors are being detected at an earlier stage, classical radical nephrectomy is being reconsidered. More conservative techniques are being proposed. To clarify the indication for synchronous adrenalectomy in radical nephrectomy for renal cell carcinoma which has been questioned since the 1980s, this study evaluates the role of adrenalectomy and recommends a new indication for adrenalectomy in renal cell carcinoma.</p><p><b>METHODS</b>A systemic search was performed, using PubMed and Google Scholar, of all English language studies published up to March 2012 that compared adrenalectomy with adrenal-sparing surgery, in surgery for renal cell carcinoma. We assessed preoperative imaging for adrenal involvement and the relationship of tumor location with adrenal metastases. Twenty-one studies (20 retrospective and 1 prospective) involving 11 736 patients were included.</p><p><b>RESULTS</b>The mean incidence of ipsilateral adrenal involvement from renal cell carcinoma was 4.5%. Synchronous adrenalectomy did not alter survival (hazard ratio (HR) = 0.89, 95% confidence interval (CI) 0.67 - 1.19, P = 0.43; odds ratio (OR) = 1.10, 95%CI 0.84 - 1.44, P = 0.49). Upper pole tumors were not associated with a higher incidence of ipsilateral adrenal metastases. Pooled preoperative imaging: sensitivity, specificity, positive predictive value and negative predictive value were 92% (95%CI 0.84 - 0.97), 95% (95%CI 0.93 - 0.96), 71.6% and 98.5% respectively.</p><p><b>CONCLUSIONS</b>Adrenal involvement from renal cell carcinoma is rare, even in advanced tumours. Synchronous adrenalectomy does not offer any benefit, even for "high risk" patients. We suggest that only patients with a positive preoperative adrenal finding on preoperative imaging for a solitary adrenal metastasis should undergo adrenalectomy as part of the radical nephrectomy.</p>
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Humanos , Neoplasias das Glândulas Suprarrenais , Cirurgia Geral , Adrenalectomia , Métodos , Carcinoma de Células Renais , Mortalidade , Cirurgia Geral , Neoplasias Renais , Mortalidade , Cirurgia Geral , Nefrectomia , Métodos , Taxa de SobrevidaRESUMO
Objective To describe the prevalence,clinical subtypes and associated risk factors of stroke in urban and rural workers from Lhasa,Tibet,and provide the evidence of prevention and treatment.Methods A retrospective,population-based descriptive analysis of 81298 urban and rural workers in the Cities Staff Medical Insurance Registry was performed; stroke and myocardial infarction were defined by the International Classification of Disease(ICD)-10 coded from hospital records; the prevalence of these 2 dieases were compared,and clinical subtypes and associated risk factors of stroke in these stroke patients were analyzed.Results Stroke patients(n=165)were included in the study with a prevalence of 202.96/100,000(95%CI:170.14-231.32),and this number was significantly larger than that of patients with myocardial infarction(n=14),enjoying a prevalence of 17/100,000.The most common subtype was cerebral infarction,followed by cerebral hemorrhage and subaraclnoid hemorrhage; the prevalence of stroke was significantly different in patients with different ages(ranged from 30 to 89,P<0.05),and the older of the population,the higher prevalence of the stroke; male population had an obviously higher prevalence of stroke than female population,and the population from Han nationality had an obviously higher prevalence of stroke than population from Tibetan nationality (P<0.05).Conclusion Stroke is the primary fatal disease for the elderly population from Lhasa,and the primary subtype of stroke is cerebral ischemia; its associated risk factors include age,gender and nationality; and combined hypertension is the main risk factor.
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<p><b>OBJECTIVE</b>To observe the therapeutic effect of massage with manipulation of supplementing marrow and kneading tendon (SMKT) on spastic cerebral palsy (CP).</p><p><b>METHODS</b>A total of 60 children with CP were randomly assigned to the treatment group and the control group equally. All were treated with rehabilitation training, but massage with SMKT was carried out additionally for those in the treatment group, five times every week and 3 months as a therapeutic course. Clinical efficacy was assessed adopting the gross motor function measurement (GMFM-66) and the revised Ashworth scale (MAS) before and after treatment.</p><p><b>RESULTS</b>All children showed significant improvements in GMFM-66 after treatment. Compared with baseline, the improvement was statistically significant (P <0.01). Significant difference was also found between the 2 groups in MAS and in GMFM scores after treatment (P <0.05).</p><p><b>CONCLUSION</b>Massage with SMKT manipulation shows a better effect than rehabilitation training therapy alone in treating spastic CP.</p>
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Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Paralisia Cerebral , Terapêutica , Massagem , Músculo Esquelético , TendõesRESUMO
<p><b>BACKGROUND</b>Bladder carcinoma is the most common malignant urological tumor in China. We present our preliminary experience and results of laparoscopic radical cystectomy (LRC) with orthotopic ileal neobladder in female patients with bladder carcinoma.</p><p><b>METHODS</b>From February 2003 to February 2008, 14 female patients with bladder carcinoma underwent LRC with orthotopic ileal neobladder. Nine of these patients underwent hysterectomy and ovariectomy, and the other 5 had preservation of the uterus and ovarian appendage. Standard bilateral pelvic lymphadenectomy was followed by radical cystectomy that was completed laparoscopically with hysterectomy and ovariectomy when needed. The tumor was removed by a 4 - 5 cm lower midline abdominal incision, followed by the construction of ileal neobladder and the extracorporeal anastomosis of ureter-neobladder. The neobladder was anastomosed to the urethral stump under a laparoscope.</p><p><b>RESULTS</b>The mean operative time and blood loss in the 14 patients were 350.2 minutes and 349.8 ml, respectively. Postoperative complications included uretero-pouch anastomotic stricture in 1 patient and pouch-vaginal fistula in 1 patient. Follow-up time of all patients ranged from 3 to 60 months, and 12 patients were followed up for more than 6 months and achieved micturition in half a year. One patient had occasional day-time urinary incontinence and 2 had night-time incontinence. Two patients who had undergone hysterectomy and ovariectomy had voiding difficulties after one year, which was treated by intermittent self-catheterization. The mean volume of the neobladder and the residual urine were 333.6 ml and 31.2 ml, respectively. Surgical margins were tumor free for all patients. One patient had bone metastasis and died 11 months after the operation.</p><p><b>CONCLUSIONS</b>LRC with orthotopic ileal neobladder in female patients is a technically feasible, safe and mini-invasive procedure with a low morbidity and acceptable neobladder function. Long-term follow-up is required to confirm the neobladder function and oncological outcomes.</p>
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Adulto , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Cistectomia , Métodos , Laparoscopia , Métodos , Resultado do Tratamento , Neoplasias da Bexiga Urinária , Cirurgia Geral , Coletores de UrinaRESUMO
<p><b>OBJECTIVE</b>To compare the clinical therapeutic effect and complications of laparoscopic radical cystectomy with orthotopic ileal neobladder (LRC-INB) with open radical cystectomy with orthotopic ileal neobladder (ORC-INB).</p><p><b>METHODS</b>A total of 171 patients were evaluated, including 63 cases with ORC-INB and 108 cases with LRC-INB from June 1994 to May 2007 at our institution. The parameters analyzed included perioperative data, postoperative complications, new bladder function and effect of tumor control.</p><p><b>RESULTS</b>There was no significant difference in demographic characteristics of patients between these 2 groups. The mean operating time was 330 min in the LRC group and 310 min in the ORC group (P > 0.05). The mean blood loss was 320 ml in the LRC group and 1100 ml in ORC group (P < 0.001). The mean oral intake after operation was 2.4 days for LRC group and 4.5 days for ORC group (P < 0.001). No perioperative death was occurred in both groups. The complication rate was 18.5% in LRC group, while 30.0% in ORC group (P < 0.05). Twelve months after operation, the day-time and night-time continence rate were 90.7% and 82.6% for the LRC group, 88.3% and 81.6% for the ORC group respectively (P > 0.05). There was no significant difference of VOL, pressure and residual urine volume (RUV) of neobladder between these 2 groups. Surgical margin were tumor free for 107 cases except one T4 case in laparoscopic group had positive margin (P > 0.05). The mean number of removed lymph node were 12 and 8 in LRC and ORC group respectively (P < 0.05). The 2 years tumor free survival rate of the same stage or grade was no significant different (P > 0.05).</p><p><b>CONCLUSIONS</b>LCR had advantages of less blood loss, shorter oral intake time, less postoperative complications, comparable continent rate and short-term tumor control with ORC. Long-term follow up is needed to confirm the oncological outcome.</p>
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Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cistectomia , Métodos , Íleo , Cirurgia Geral , Laparoscopia , Laparotomia , Resultado do Tratamento , Neoplasias da Bexiga Urinária , Cirurgia Geral , Derivação Urinária , MétodosRESUMO
Objective To explore the effect of naloxone (NLX) on patients with severe head injury and herniation of brain after the craniotomy. Methods A total of 108 patients with severe brain injury and herniation of brain were divided into 2groups: NLX group was treated with NLX and general therapy and control group was treated only by general therapy after the craniotomy. The abnormal respiration and heartbeat, recovery of consciousness at the early period and the prognosis at the later period were observed and all the data were analyzed statistically. Results The abnormal respiration and heartbeat of patients were significantly less in NLX group than in control group in the first 7d after injury(P<0.01). More patients revived in NLX group than in control group 14d and 1month after injury (P<0.05). The prognosis of NLX group was significantly better than that of control group 3months after injury (P<0.05). Conclusion The early administration of NLX in patients with severe head injury and herniation of brain after the craniotomy Can ameliorate the function of respiration and circulation, shorten the coma duration, reduce the incidence of disability and death, and improve the nerve function.
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<p><b>OBJECTIVE</b>To study the validity and reliability of the Demirjian distinguish software on dental age estimation.</p><p><b>METHOD</b>The dental age of 60 children were estimated with both the software three times and manual measures.</p><p><b>RESULTS</b>The correlation coefficients of dental age estimated by the software and by manual measure was 0.974 (female) (P > 0.1) and 0.970 (male) (P > 0.05); the coefficients of interclass correlation of each dental age estimated by the software was 0.977 (female) (P > 0.1) and 0.977 (male) (P > 0.05).</p><p><b>CONCLUSION</b>Demirjian distinguish software has high validity and reliability in estimating dental age.</p>
Assuntos
Adolescente , Criança , Feminino , Humanos , Masculino , Determinação da Idade pelos Dentes , Métodos , Reprodutibilidade dos Testes , SoftwareRESUMO
<p><b>OBJECTIVE</b>We evaluated our method and effects of needle laparoscopic varicocelectomy for the treatment of varicocele.</p><p><b>METHODS</b>72 patients (105 lateral) diagnosed varicocele were performed laparoscopic varicocelectomy under epidural combined intravenous anesthesia from Feb, 2003 to Apr, 2005. Two 2 mm incisions and one 5 mm incision were made on the midline of lower abdomen, by which two 2 mm trocars and one 5 mm trocar were introduced. Vessel-sealing device (Ligasure) was used to seal the internal spermatic veins.</p><p><b>RESULTS</b>All operations were completed successfully. Mean operation time was 15 minutes unilateral and 21 minutes bilateral. The patients were hospitalized for 3 to 5 days after procedure. Follow-up was scheduled for 6 to 12 months and there was no recurrence.</p><p><b>CONCLUSION</b>Needle laparoscopic varicocelectomy gives favorable effect with minimal invasion, rapid recovery, which is the best choice for the treatment of varicocele.</p>
Assuntos
Adolescente , Adulto , Criança , Humanos , Masculino , Pessoa de Meia-Idade , Seguimentos , Laparoscopia , Ligadura , Métodos , Cordão Espermático , Cirurgia Geral , Varicocele , Cirurgia GeralRESUMO
<p><b>OBJECTIVE</b>To identify Radix Scutellariae (Huangqin) of different growth years, to distinguish whether it's wild or cultivated and to provide useful information for the quality control of Huangqin crude drug.</p><p><b>METHOD</b>By using morphological and histological methods, we studied 87 individuals of 45 specimens from 12 habitats of 5 provinces of China, which grew wild or were cultivated in different growing years. Moreover, 22 commercial samples of Huangqin from 7 provinces were also investigated.</p><p><b>RESULT</b>The identification was performed base on morphological and histological characteristics, such as, the shape, color, cork, remaining stems, decayed central xylem, and vessels arrangement, xylem cork ring, growth rings, etc.</p><p><b>CONCLUSION</b>We established an identification method for distinguishing Huangqin wild or cultivated in different growing years. Furthermore, the structure of annual rings in the transection of Radix Scutellariae has been discovered for the first time.</p>