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Drought stress has a significant impact on the quality and quantity of lake water. Understanding this impact is crucial for preventing water security risks and pollution recovery. However, there is a lack of systemic understanding of how drought affects water quality and quantity, and how they change in multiple dimensions. This manuscript established a synthesized methodology with the principles to judge the applicability and three steps of application to detect the change in water quality and water level under severe drought in Xingyun Lake, China. Results show that (1) The water level and water quality of Xingyun Lake have a synchronous and evident response to drought during 2009-2014. The rainfall during 2008-2015 declined by 22.9 % to normal, and the inundated area and lake water depth in 2012 decreased by 10.50 % from 2002 to 1.38 m to the average depth, respectively. The pollution index climbed above 1.21 after 2008, fluctuating around 1.42. (2) Under drought, the water quality indicators significantly changed in the terms of the overall feature, trend, eigenvalue, and morphological characteristics. The water quality indicators of Set2008-2015 are significantly different from set2000-2007 and not in the groups of set1994-2000. The morphological characteristics of water quality indicators in set2008-2015 differs significantly from that in set2000-2007 shown by the minimum, maximum, median, quartiles, and extreme values. (3) Although NH3-N showed no significant change, the water quality deteriorated in the physical, chemical, and biological aspects. The TP, IMN, and BOD5 changed more evidently than DO and NH3-N. (4) Water quality grade and indicator concentration deteriorated significantly and sharply under severe drought and are threatened deeply by TP and TN. The synthesized methodology is scientifically constructed and canbe employed in the characteristics cognition of water quality and water level to severe drought in and out of this research. And the intervention time and various regulating measures for pollution degradation and water quality recovery canbe constructed based on the multi-dimensional analysis of water quality change under drought evolution.
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This study investigated the impact of axial load on the dynamic response of reinforced concrete (RC) members to asymmetrical lateral impact loads. A series of asymmetrical-span impact tests were conducted on circular and square RC members with and without Carbon Fiber Reinforced Polymers (CFRP) while varying the axial compression ratios. The impact process was simulated using ABAQUS software, and the time history curves of deflection and impact were measured. The study found that specific impact loads caused bending and shearing failures. The axial compression ratio ranged from 0.05 to 0.13 when the impact curve reached its maximum deflection before the component's impact resistance decreased. Analysis of the impact point and inclined crack location revealed that axial load affects the maximum local concrete. The speed of inclined crack penetration and inclined cracks take longer to form, with weaker resistance to damage to local concrete when the axial compression ratio is between 0.05 and 0.13. When the axial compression ratio is greater than 0.13, inclined cracks form sooner with more brittle and severe damage to the impact point's concrete. The study also identified key parameters affecting the dynamic response of RC members, including impact height, CFRP layer thickness, axial force, and impact location. Thicker CFRP layers in RC can improve impact resistance, especially when the impact location is farther from the center. However, there is a limit to the impact of axial force on this resistance.
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Data Compression , Polymers , Carbon Fiber , PlasticsABSTRACT
Objective:To investigate the risk factors for neoplasia in pale lesions of gastric mucosa, and provide clinical clues for early diagnosis.Methods:A total of 402 patients with gastric mucosal pale lesions who underwent gastroscopy at The Seventh Medical Center of Chinese PLA General Hospital from January 2020 to May 2021 were enrolled in the retrospective analysis. Data of gender and age of patients, degree of gastric mucosal atrophy, lesion boundaries, size, location, morphology, narrow band imaging magnifying endoscopy (NBI-ME) findings and histopathological results, etc. were collected for analysis. Multivariate logistic regression was used to analyze the risk factors for diagnosed as tumor.Results:Among 402 cases, 33 cases (8.2%) were diagnosed as neoplasia, and 23 cases (5.7%) were high-risk epithelial neoplasia (high grade dysplasia or early gastric cancer). The age of patients, the degree of gastric mucosal atrophy, lesion size, surface depression, NBI-ME positive findings, surface microvessels and surface microstructures were related to neoplasia of gastric mucosal pale lesion ( P<0.05). While the age of patients, the degree of gastric mucosal atrophy, lesion size, surface depression, surface microstructures were related to high-risk epithelial neoplasia of gastric mucosal pale lesion ( P<0.05). Multivariate logistic regression analysis showed that lesion diameter<20 mm ( OR=4.487, 95% CI: 1.776-11.332, P=0.001) and NBI-ME positive findings ( OR=40.510, 95% CI: 1.610-1 019.456, P=0.024) were independent risk factors for neoplasia, and abnormal surface microstructure of lesion was an independent risk factor for high-risk epithelial neoplasia ( OR=0.003, 95% CI: 0.000-1.587, P<0.001). Conclusion:Abnormal surface microstructure, the lesion size, and NBI-ME positive findings are important clues for the diagnosis of neoplasia in the pale lesions.
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Traffic accidents and derailed train-related incidents have occurred more often than ever in recent years, resulting in some economic damage and casualties. Reinforced concrete (RC) constructions often involve derailed train and vehicle accidents. Rarely are such side collisions studied in previous studies. To do this, high-fidelity simulation-based finite-element (FE) models are created in this paper to accurately simulate the collision of circular RC members with a derailed train. The reinforced concrete member structure is common in high-speed railway stations. The impact energy of the impact body is significant, causing structural member failure. It analyses the dynamic behavior of reinforced concrete members under unequal span impact loads. Numerical implementations of impact issues are discussed from the perspective of geometric, contact, and material properties. The reliability and precision of the ABAQUS code to solve impact issues are verified by comparing failure modes, impact, and deflection time history experimental outputs. By analysing the impact response characteristics, used the control variables to study the failure process and mode (including the characteristics of impact and reaction forces, deflection time history curve, impact force-deflection curve, and bearing reaction force-deflection curve). The reinforcement ratio, impact velocity, concrete strength, and slenderness ratio significantly affect shear crack pattern and development. Changes in impact velocity and slenderness ratio also affect member failure modes.
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@#Objective To analyze the occupational burnout status and its influencing factors of border guards in the prevention （ - ）Methods and control of coronavirus disease COVID 19 . A total of 1 313 border guards who participate in the prevention and control of epidemic diseases were selected as research subjects using the random cluster sampling method. Military Occupational Burnout Scale and Military Occupational Stress Scale were used to investigate the occupational burnout status and Results occupational stress in the research subjects. The median and 25th and 75th percentiles of military occupational （ ， ） （ ， ）， burnout and occupational stress total scores were 9.0 3.0 15.0 and 76.0 70.0 86.0 respectively. About 73.1% of the subjects were suffered from high occupational stress. The results of multiple linear regression analysis indicated that the higher the scores of interpersonal relationship, military special life, work pressure, unclear role and leadership ability factor in P occupational stress, and the lower the score of personal development, the more serious the occupational burnout (all <0.05 ) ， after excluding the influence of confounding factors; subjects with panic psychology inconvenience caused by closed ， management fear on accountability for poor prevention and no personal hobbies had more serious occupational burnout than （ P ） Conclusion - ， subjects without those factors all <0.05 . In the period of COVID 19 prevention the level of occupational burnout and occupational stress of border guards were generally low. The occupational burnout was mainly affected by occupational stress and fear of the epidemic.
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Objective:To study the effectiveness of a strategy for detecting early gastric cancer using high-definition gastroscopy.Methods:A total of 849 patients over 35 years old who underwent gastroscopy in the Seventh Medical Center of PLA General Hospital from December 2018 to January 2019 were enrolled to a prospective study. During gastroscopy, biopsies were taken at any suspicious lesions in patients who had never been infected with Helicobacter pylori. In ulcer-type lesions, biopsies were taken at the edge of the ulcer. Outside the atrophic area, biopsies were taken at lesions in the cardia which were reddish under white light, or lesions in the non-cardiac area which were white or showed clear borders under white light. Inside the atrophic area, biopsies were taken at elevated lesions with clear borders or irregular depressions on the top, or flat/depressed lesions with irregular borders or being ocherous under narrow band imaging. In addition, biopsies were performed on any lesion that did not meet the above standard but was considered necessary. The high-risk patients were followed up by gastroscopy to observe the detection and missed diagnosis of neoplasm that meet the above standard, and to determine the sensitivity and positive predictive value of the strategy. Results:A total of 548 patients were biopsied (781 lesions). Among the 327 lesions that met the above standard, 16 lesions (4.9%) were diagnosed as epithelial neoplasm, of which 10 (3.1%) were high-grade neoplasm. Among the 454 lesions that did not meet the standard, only 1 (0.2%) epithelial neoplasm was diagnosed, and there was no high-grade neoplasm. The positive predictive value of this screening strategy for gastric epithelial neoplasm and high-grade neoplasm was higher than those who did not meet the standard (4.9% VS 0.2%, χ2=19.49, P<0.01; 3.1% VS 0, P<0.001). There were 146 patients (17.2%, 146/849) followed up by gastroscopy. During the follow-up, 2 high-grade intramucosal neoplasms were found. 84.2% (16/19) of epithelial tumors and 83.3% (10/12) of high-grade neoplasm were detected during the initial gastroscopy. Conclusion:This screening strategy can efficiently detect early gastric cancer under high-definition gastroscopy.
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RGB-thermal salient object detection (SOD) aims to segment the common prominent regions of visible image and corresponding thermal infrared image that we call it RGBT SOD. Existing methods don't fully explore and exploit the potentials of complementarity of different modalities and multi-type cues of image contents, which play a vital role in achieving accurate results. In this paper, we propose a multi-interactive dual-decoder to mine and model the multi-type interactions for accurate RGBT SOD. In specific, we first encode two modalities into multi-level multi-modal feature representations. Then, we design a novel dual-decoder to conduct the interactions of multi-level features, two modalities and global contexts. With these interactions, our method works well in diversely challenging scenarios even in the presence of invalid modality. Finally, we carry out extensive experiments on public RGBT and RGBD SOD datasets, and the results show that the proposed method achieves the outstanding performance against state-of-the-art algorithms. The source code has been released at: https://github.com/lz118/Multi-interactive-Dual-decoder.
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Objective:To analyze the endoscopic and histological characteristics of Helicobacter pylori ( HP)-negative early gastric cancer (EGC) and high grade intraepithelial neoplasia (HGIN). Methods:Data of patients diagnosed as having EGC or HGIN confirmed by pathology at the Seventh Medical Center of Chinese People′s Liberation Army General Hospital from January 2013 to January 2020 were collected. Patients were included according to the diagnostic criteria of HP-negative gastric cancer, and their endoscopic features and histopathological characteristics were retrospectively analyzed. Results:Among 469 lesions of EGC/HGIN, HP-negative lesions accounted for 2.1% (10/469), which included 3 signet ring cell carcinomas, 3 fundic gland type carcinomas, 1 foveolar adenocarcinoma, 1 HGIN of the cardia, 1 familial adenomatous polyposis with gastric HGIN, and 1 Lynch syndrome with gastric HGIN. The 3 cases of signet ring cell carcinoma were all whitish flat/depressed lesions and commonly seen in the lower part of the stomach (2/3). Most of the 7 cases of differentiated EGC/HGIN were elevated type (5/7) and commonly seen in the upper and middle stomach (6/7). Conclusion:HP-negative EGCs are usually solitary lesions under gastroscopy. Undifferentiated type mostly appears whitish flat/depressed in the lower part of the stomach, while differentiated type appears elevated in the upper and middle part.
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Objective:To propose a strategy for detecting early gastric cancer (EGC) under high-definition gastroscopy.Methods:Data of 469 lesions of EGC or high grade intraepithelial neoplasia (HGIN) confirmed by pathology detected at The Seventh Medical Center of Chinese People′s Liberation Army General Hospital from January 2013 to January 2020 were collected and gastroscopic images were re-interpreted. The Helicobacter pylori ( HP) infection status, lesion location in the area of atrophy or at the cardia, morphological type of lesions, lesions with/without clear or regular boundary, and lesion color were analyzed for morphological characteristics of EGC and HGIN under high-definition gastroscopy. Results:Among the 469 lesions of EGC or HGIN, HP-negative lesions accounted for 2.1% (10/469) and ulcerative lesions for 7.7% (36/469). Among non-ulcerative lesions of suspected HP infection ( n=423), there were 28 lesions in the cardia outside the atrophic area and 82.1% (23/28) were reddish under white light imaging. There were 29 non-cardiac lesions outside the atrophic area and 82.8% (24/29) were white or showed clear border under white light imaging. Inside the atrophic area, there were 73 elevated lesions, 95.9% (70/73) of which had clear border or irregular depression on the top. There were 293 flat/depressed lesions in the atrophic area, and 90.8% (266/293) had irregular border or were brown under narrow band imaging. Conclusion:According to the status of HP infection, the location and morphological category of lesions, above endoscopic features can be used as clues to detect EGC and HGIN.
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Objective To study the differences of endoscopic submucosal dissection ( ESD ) for colorectal tumors of different diameters. Methods Data of 210 cases which were treated with ESD for colorectal tumors at the Endoscopy Center, the Seventh Medical Center of PLA General Hospital from October 2012 to December 2015 were retrospectively analyzed. The lesions were divided into two groups according to different diameters (≥4. 0 cm group and <4. 0 cm group) for comparative analysis of related factors. Results The mean procedure time of ESD for 210 colorectal tumor cases was 50. 3±42. 7 min and the mean size of lesions was 7. 98 ± 10. 84 cm2 . En bloc resection rate was 91. 4％, R0 resection rate was 90. 5％, and the curative resection rate was 88. 6％. Perforation rate was 5. 2％ (11/210), and the late hemorrhage rate was 0. 5％ (1/210). Compared with lesions < 4. 0 cm, those ≥ 4. 0 cm required longer resection time (79. 63±53. 91 min VS 35. 28±24. 99 min, P<0. 001); and the lesions were mainly located in the rectum ( 61. 97％) . LSTs were mainly mixed granular/nongranular type ( 54. 93％);en bloc resection rate, complete resection rate and curative resection rate of the tumors≥4. 0 cm were all lower than those of tumors < 4. 0 cm. The difference in complete resection rate was statistically significant ( 85. 92％ VS 94. 24％;P=0. 041) . The perforation rate ( 7. 04％) was higher in≥4. 0 cm group, but the difference was not statistically significant. Conclusions ESD of colorectal tumors of diameters ≥ 4. 0 cm requires longer time with higher operation risk. Additionally, physicians should be more careful with non-rectal lesions.
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Objective To investigate the protective effect of excretory-secretory protein (AES) from adult Trichinella spiralis on ovalbumin (OVA)-induced allergic rhinitis in mice. Methods Eighteen female BALB/c mice were randomly divided into three groups, including the blank control group (Group A), OVA-induced rhinitis group (Group B) and AES treatment group (Group C). Mice in Group A were given PBS. Mice in Group B were intraperitoneally injected with antigen adjuvant suspension for systemic sensitization, once every other day for seven times; then, local excitation was intranasally induced with 5% OVA solution once a day for seven times to establish a mouse model of allergic rhinitis. In addition to induction of allergic rhinitis, mice in Group C were given 25 μg AES at baseline sensitization and local excitation. Following the final challenge, mice were observed for 30 min in each group, and the behavioral score was evaluated. The serum levels of IFN-γ, IL-4, IL-5, IL-10 and TGF-β were determined using an enzyme-linked immunosorbent assay in mice, and the pathological changes of mouse nasal mucosa were observed under a microscope. Results There was a significant difference in the mouse behavioral scores among the three groups (F = 110.12, P < 0.01). The mouse behavioral score was significantly higher in Group B than in Group A (7.17 ± 0.75 vs. 1.33 ± 0.52, P < 0.01), and more remarkable pathological damages of mouse nasal mucosa were seen in Group B than in Group A, while the mouse behavioral score was significantly decreased in Group C than in Group B (P < 0.01), and the pathological damages of mouse nasal mucosa remarkably alleviated in Group C relative to Group B. There was a significant difference in serum IFN-γ level among the three groups (F = 7.50, P < 0.01) and the serum IFN-γ level in Group B was significantly lower than in group A and C (both P < 0.05). There were significant differences in serum IL-4 (F = 470.81, P < 0.01) and IL-5 levels (F =68.20, P < 0.01) among the three groups, and significantly greater serum IL-4 and IL-5 levels were detected in Group B than in Group A (P < 0.01), while significantly lower serum IL-4 and IL-5 levels were detected in Group C than in Group B (P < 0.01). There were significant differences in serum IL-10 (F = 174.91, P < 0.01) and TGF-β levels (F = 9.39, P < 0.01) among the three groups, and significantly greater serum IL-10 and TGF-β levels were seen in Group C than in Group B (both P < 0.05). Conclusion T. spiralis AES has a remarkable protective activity against OVA-induced allergic rhinitis in mice.
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Objective To investigate the protective effect of excretory-secretory protein (AES) from adult Trichinella spiralis on ovalbumin (OVA)-induced allergic rhinitis in mice. Methods Eighteen female BALB/c mice were randomly divided into three groups, including the blank control group (Group A), OVA-induced rhinitis group (Group B) and AES treatment group (Group C). Mice in Group A were given PBS. Mice in Group B were intraperitoneally injected with antigen adjuvant suspension for systemic sensitization, once every other day for seven times; then, local excitation was intranasally induced with 5% OVA solution once a day for seven times to establish a mouse model of allergic rhinitis. In addition to induction of allergic rhinitis, mice in Group C were given 25 μg AES at baseline sensitization and local excitation. Following the final challenge, mice were observed for 30 min in each group, and the behavioral score was evaluated. The serum levels of IFN-γ, IL-4, IL-5, IL-10 and TGF-β were determined using an enzyme-linked immunosorbent assay in mice, and the pathological changes of mouse nasal mucosa were observed under a microscope. Results There was a significant difference in the mouse behavioral scores among the three groups (F = 110.12, P < 0.01). The mouse behavioral score was significantly higher in Group B than in Group A (7.17 ± 0.75 vs. 1.33 ± 0.52, P < 0.01), and more remarkable pathological damages of mouse nasal mucosa were seen in Group B than in Group A, while the mouse behavioral score was significantly decreased in Group C than in Group B (P < 0.01), and the pathological damages of mouse nasal mucosa remarkably alleviated in Group C relative to Group B. There was a significant difference in serum IFN-γ level among the three groups (F = 7.50, P < 0.01) and the serum IFN-γ level in Group B was significantly lower than in group A and C (both P < 0.05). There were significant differences in serum IL-4 (F = 470.81, P < 0.01) and IL-5 levels (F =68.20, P < 0.01) among the three groups, and significantly greater serum IL-4 and IL-5 levels were detected in Group B than in Group A (P < 0.01), while significantly lower serum IL-4 and IL-5 levels were detected in Group C than in Group B (P < 0.01). There were significant differences in serum IL-10 (F = 174.91, P < 0.01) and TGF-β levels (F = 9.39, P < 0.01) among the three groups, and significantly greater serum IL-10 and TGF-β levels were seen in Group C than in Group B (both P < 0.05). Conclusion T. spiralis AES has a remarkable protective activity against OVA-induced allergic rhinitis in mice.
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Objective To explore the clinical significance of colonoscopy follow-up in Chinese Lynch syndrome mismatch repair (MMR) gene mutation carriers.Methods The results of colonoscopy follow-up was analyzed in 194 MMR gene mutation carriers of 50 Lynch syndrome families.The follow-up period was from April 2001 to November 2016.The detection rates of advanced adenomas and colorectal cancers,five-year survival rate and ten year survival rate were compared between 123 patients of regular follow-up group (colonoscopy interval less than two years) and 71 patients of irregular follow-up group (time colonoscopy interval more than two years).T test,chi-square test and Kaplan-Meier method were performed for statistically analysis.Results The incidence of colorectal cancer of irregular follow up group was significantly higher than that of regular follow-up group (57.7％,41/71 vs 22.8％,28/123);and the difference was statistically significant (x2 =24.00,P＜0.01).The average age at diagnosis for colorectal cancer in irregular follow up group was younger than that of regular follow up group ((45.3 ± 1.9) years vs (48.7±1.8) years);and the difference was statistically significant (t=4.10,P＜0.01).In regular follow-up group,28.6％ (8/28) advanced-stage colorectal cancer (TNM Ⅲ or Ⅳ) was found,while in irregular follow up group,73.2 ％ (30/41) advanced-stage colorectal cancer was found,and there was statistically significant difference in pathological stage between two groups (x2 =4.90,P =0.032).The five year and ten-year survival rates of regular follow-up group were 96.2 ％ and 85.1 ％,respectively,which were both higher than those of irregular follow-up group (46.3 ％ and 28.7 ％);and the differences were statistically significant (x2 =13.20 and 14.80,both P＜0.05).The incidence of advanced adenomas of irregular follow up group was significantly higher than that of regular follow-up group (49.3％,35/71 vs 18.7％,23/123);and the difference was statistically significant (x2 =20.10,P＜0.05).The detection rate of advanced adenomas of MMR gene mutation carriers was higher than those without MMR mutation gene (85.4％,35/41 vs 14.6％,6/41);and the difference was statistically significant (x2 =5.20,P＜ 0.05).Conclusion Regular colonoscopy surveillance may decrease the incidence and mortality of colorectal cancer in MMR mutation carriers of Lynch syndrome families,and increase five-year and tenyear survival rates.
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<p><b>BACKGROUND</b>Mounting evidence has demonstrated that hypoxia-inducible factor-1α (HIF-1α) could attenuate brain injuries after cerebral ischemia and reperfusion (CIR). However, few reports have addressed the therapeutic efficacies of a recombinant adenovirus vector containing HIF-1α (AdHIF-1α) gene after ischemia and reperfusion. The aim of this study was to examine the antiapoptotic and neuroprotective effects of AdHIF-1α gene for cerebral injuries after ischemia and reperfusion in rats.</p><p><b>METHODS</b>From February to December 2016, male Sprague-Dawley rats were randomly divided into normal, sham, CIR, AdHIF-1α, and recombinant adenovirus (Ad) groups. Middle cerebral artery occlusion model was established by Longa's method and reperfusion resumed at 2 h postocclusion. AdHIF-1α solution, Ad solution, and phosphate-buffered saline were injected into the right lateral ventricle of rats in AdHIF-1α, Ad, and CIR groups. Brain tissue sections were observed under fluorescent microscope to confirm the definite expression of recombinant adenovirus in Ad and AdHIF-1α groups. The expressions of HIF-1α protein were analyzed by immunohistochemical staining at 6 h, 24 h, and 72 h postreperfusion. Brain water content and neurological deficit scores were evaluated at 6 h, 24 h, and 72 h postreperfusion. Pathological brain injuries were examined after hematoxylin and eosin stain and nerve cell apoptosis was measured after terminal-deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL) stain at 72 h postreperfusion. Comparisons were conducted with one-way analysis of variance by post hoc Scheffe's test among different experimental groups.</p><p><b>RESULTS</b>Green fluorescent protein was successfully expressed in brain tissue of Ad and AdHIF-1α groups from 24 h to 21 days postinjection. As detected by immunohistochemical staining, the expressions of HIF-1α protein were obviously enhanced in AdHIF-1α group than those in CIR and Ad groups at 24 h and 72 h postreperfusion, respectively. There were significant reductions of brain water content (78.83% ± 0.34% vs. 83.21% ± 0.50% and 83.35% ± 0.32%; 84.13% ± 0.24% vs. 89.76% ± 0.34% and 89.70% ± 0.18%; respectively; all P < 0.05) and neurological deficit scores (2.90 ± 0.74 vs. 3.50 ± 0.52 and 3.60 ± 0.53 at 24 h; 2.40 ± 0.84 vs. 3.60 ± 0.52 and 3.50 ± 0.53 at 72 h; respectively; all P < 0.05) in AdHIF-1α group versus CIR and Ad groups at 24 h and 72 h postreperfusion, respectively. The pathologic changes of AdHIF-1α group were milder than those in CIR and Ad groups at 72 h postreperfusion. The percentage of TUNEL-positive cells in cerebral subcortex decreased significantly in AdHIF-1α group versus CIR and Ad groups at 72 h postreperfusion (P < 0.05).</p><p><b>CONCLUSION</b>AdHIF-1α has an obvious neuroprotective effect on ischemia and reperfusion in rat brains possibly through inhibiting the apoptosis of nerve cells.</p>
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Objective To investigate the value and safety of colonoscopy in patients aged 80 years and over.Methods Clinical and endoscopic data of 1 249 patients aged 80 years and over collected from December 2005 to December 2015 at PLA army General Hospital were analyzed retrospectively.Results The average age was 83.03 years.Reasons for receiving colonoscopy included constipation with abdominal distension(19.38 ％)and hematochezia(10.57％).The completion rate of colonoscopy for the entire length was 94.50 ％.There were no abnormal findings in 492 cases (39.39 ％).Colonic polyps (31.62 ％) and colorectal cancer (14.25 ％) were among the major lesions detected with colonoscopy.Colorectal neoplasms were found in 58.33％ of the 132 patients with hematochezia.The total complication rate from colonoscopy and treatment was 0.72％,with the complication rate from treatment at 1.32％.Conclusions Constipation with abdominal distension and hematoehezia are the main reasons for undergoing colonoscopy for very elderly patients.Colon polyps and colorectal cancer are common disorders in elderly patients over 80 years of age and people with hematochezia in this age group are at high risk of having colorectal cancer.Colonoscopy is a safe and effective procedure and an important examination method for very elderly patients with hematochezia.
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Objective To evaluate the efficacy of premedication of pronase and simethicone before upper gastrointestinal endoscopy. Methods A total of 4 690 patients undergoing upper gastrointestinal en?doscopy from January 2014 to November 2014 were recruited at gastrointestinal endoscopy center in Beijing Military General Hospital. All patients were randomized into 3 groups. The pronase plus simethicone group( n=1 602) took 40 ml mixed solution of pronase, sodium bicarbonate and simethicone orally 20 minutes before endoscopy. The simethicone group( n=1 548) took 40 ml simethicone orally 20 minutes before endoscopy. And the control group( n=1 540) took 10 ml lidocaine hydrochloride mucilage orally 5 minutes before endos?copy. The visibility during gastroscopy was observed. Results Each patient underwent gastroscopy, and no severe adverse event occurred during the procedure. The visibility of 82?3%( n=1 318) of the pronase plus simethicone group, 67?7%( n=1 048) of the simethicone group and 28?1% patients( n=432) of the control group respectively reached grade A or B. The visibility during gastroscopy in the pronase plus simethicone group was higher than that in the simethicone group(χ2=89?42, P=0?000) , while that in the simethicone group was higher than that of the control group(χ2=486?30, P=0?000). Conclusion Premedication of pronase and simethicone can improve the visibility during gastroscopy.
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BACKGROUND/AIMS: Early colorectal (CR) neoplasm can be cured by endoscopic submucosal dissection (ESD), but clinical experience and factors associated with complications from ESD for CR neoplasms in China have not been reported. METHODS: Seventy-eight cases of early CR neoplasm treated with endoscopic resection performed between December 2012 and December 2013 at Beijing Military General Hospital were included. Factors associated with ESD complications and procedure times were evaluated. RESULTS: The en bloc resection rate was 88.5% (69/78), tumor size was 32.1+/-10.7 mm, and procedure time was 71.8+/-49.5 minutes. The major complication was perforation, which occurred in 8.97% of the ESD procedures. Multivariate logistic regression analysis indicated that only tumor size (p=0.022) was associated with ESD perforation. Tumor size (p<0.001) and the non-lifting sign (p=0.017) were independent factors for procedure time, and procedure time (p=0.016) was a key factor for en bloc resection. After a median 10 months (range, 4 to 16) of follow-up, no patients had local recurrence. CONCLUSIONS: This study indicated that ESD is an applicable method for large early CR neoplasm in the colon and rectum. Tumor size and the non-lifting sign might be considerable factors for increased complication rate and procedural time of ESD.
Subject(s)
Humans , China , Colon , Colorectal Neoplasms , Follow-Up Studies , Hospitals, General , Logistic Models , Military Personnel , Rectum , RecurrenceABSTRACT
<p><b>OBJECTIVE</b>To observe the therapeutic effects of continuous plasma filtration absorption (CPFA) treatment on burn sepsis.</p><p><b>METHODS</b>Thirty burn patients with sepsis hospitalized in Beijing Fengtai You'anmen Hospital from July 2009 to October 2012 were treated by CPFA for twice besides routine treatment. The blood samples were collected at five sites (A, B, C, D, and E, respectively) of blood purification equipment before and after CPFA, before and after hemoabsorption, and before hemofiltration. The plasma levels of TNF-α, IL-1β, IL-6, IL-10, interleukin-1 receptor antagonist (IL-1RA), soluble tumor necrosis factor receptor (sTNFR) I , and sTNFR-II from sites A, C, and E were determined with ELISA before CPFA was performed for the first time, and those from sites B and D were determined with ELISA after CPFA was performed for the first time. Plasma levels of the above-mentioned cytokines from sites A and B were determined with ELISA before CPFA and after CPFA was performed for the second time. The data of plasma levels of IL-1βP3, IL-1RA, sTNFR-I, sTNFR-II, and TNF-α before CPFA and after CPFA was performed for the second time were collected for calculation of the ratios of IL-1RA to IL-1β and sTNFR-I plus sTNFR-II to TNF-α. The expression rate of human leukocyte antigen DR (HLA-DR) on the CD14 positive monocytes, acute physiology and chronic health evaluation (APACHE) II score, body temperature, pulse, respiratory rate, and leukocyte count of patients were evaluated or recorded before CPFA and after CPFA was performed for the second time. Patients'condition was observed. Data were processed with paired t test.</p><p><b>RESULTS</b>The plasma levels of TNF-α, IL-1β, IL-6 and IL-10 from site B after CPFA was performed for the second time were significantly lower than those from site A before CPFA was performed for the first time (with t values respectively 7.05, 5.23, 4.73, 2.37, P values below 0.01). After CPFA was performed for the first time, the plasma levels of TNF-α, IL-1β, and IL-6 from site D were significantly lower than those from site C before CPFA was performed for the first time (with t values respectively 5.48, 2. 17, 1.78, P < 0.05 or P <0.01). The plasma levels of all cytokines were close between site B after CPFA was performed for the first time and site E before CPFA was performed for the first time (with t values from 0.04 to 1.05, P values above 0.05). The plasma levels of TNF-α, IL-1β, and IL-6 from site B after CPFA was performed for the second time were significantly lower than those from site A before CPFA was performed for the second time (with t values from 1.87 to 5.93, P <0.05 or P <0.01). The ratios of IL-1RA to IL-1β and sTNFR-I plus sTNFR-II to TNF-α, and expression rate of HLA-DR were increased significantly after CPFA was performed for the second time as compared with those before CPFA (with t values from 3.99 to 7. 80, P values below 0.01). APACHE II score after CPFA was performed for the second time was 11 ± 6, which was lower than that before CPFA (22 ± 7, t =4.63, P <0.01). After CPFA was performed for the second time, body temperature, pulse, and respiratory rate of patients were improved (with t values from 1.95 to 3.55, P values below 0.05) , and the leukocyte count was significantly decreased (t =4.36, P <0.01) as compared with those before CPFA. All patients survived and were discharged with length of stay of (27 ± 31) d, and no adverse effects occurred during CPFA treatment.</p><p><b>CONCLUSIONS</b>CPFA, which combines hemoabsorption and hemofiltration, can facilitate the treatment of burn sepsis by decreasing the level of pro-inflammatory cytokines efficiently, alleviating systemic inflammatory response, and improving the immune status.</p>
Subject(s)
Aged , Humans , Adsorption , Biomarkers , Blood , Burns , Blood , Allergy and Immunology , Cytokines , Blood , Fluid Therapy , Hemofiltration , Methods , Hospitalization , Inflammation Mediators , Blood , Interleukin 1 Receptor Antagonist Protein , Blood , Interleukin-10 , Blood , Interleukin-6 , Blood , Sepsis , Blood , Allergy and Immunology , Therapeutics , Treatment Outcome , Tumor Necrosis Factor-alphaABSTRACT
[Objective]To evaluated the distraction-resisting force contributed by gastrocnemius during tibial lengthening.The force contributed by gastrocnemius during both the distraction and consolidation phases in a rabbit model of tibial lengthening were measured by an in-line strain gauged bilateral fixator.[Method]Sixteen immature New Zealand White rabbits underwent 30% (left) tibial diaphyseal lengthening at a rate of two 0.4 mm increments per day.[Result]The contribution of the gastrocnemius distraction-resisting force at the end of lengthening (11?5N,25%?7%) was statistically higher than that of 5 weeks later (3?1 N,13%?5%)(P
ABSTRACT
[Objective]To measure the in vivo knee joint reaction force in a rabbit model of tibial diaphyseal lengthening.[Method]Sixteen immature (8 weeks old) New Zealand White rabbits were underwent 30% (left) tibial diaphyseal lengthening at a rate of two 0.4 mm incremental lengthenings per day.The knee joint reaction force was measured at the end of lengthening (8 rabbits,13 weeks old) and 5 weeks later (8 rabbits,18 weeks old).An instrumented bilateral distractor and an extensometer were fixed cross the knee joint.The joint distraction force and distraction displacement were measured immediately after each incremental distraction of the joint.[Result]The joint reaction force on the lengthened side was significantly higher than that of the control side at both time points (44.4?7.8 N v.27.2?4.0 N at 13 weeks of age,44.3?6.5 N v.31.3?3.0 N at 18 weeks of age).[Conclusion]The knee joint reactive force could be increased in 30% tibial disphyseal lengthening which potentially could lead to the risk of damage to artic ular cartilage.
