The diagnostic value of changes in peripheral blood cell ratioin children with infectious mononucleosis / 西安交通大学学报(医学版)

【Objective】 To investigate the diagnostic value of neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte (MLR), and lymphocyte (LYM) count in children with infectious mononucleosis (IM). 【Methods】 Clinical and laboratory data of 134 IM children hospitalized between September 2017 and March 2020 were collected. A total of 60 healthy children during the same period were selected as the control group. The subjects’ NLR, MLR, and LYM were calculated according to the results of peripheral blood. The values of NLR, MLR, and LYM in diagnosing and predicting IM were analyzed with ROC. 【Results】 The MLR and LYM values of IM children were significantly higher than those of the control group (P0.05). ROC results showed that the area under the ROC curve (AUC) of NLR was 0.397, AUC of MLR was 0.648, and LYM's AUC was 0.680. The ROC curve AUC of MLR+LYM was 0.878, the optimal threshold was 0.59, the sensitivity was 82.09%, and the specificity was 85.00%. 【Conclusion】 MLR and LYM are independent biomarkers for the prediction of IM in children.

Inhibition of NLRP9b attenuates acute lung injury through suppressing inflammation, apoptosis and oxidative stress in murine and cell models.

Acute lung injury (ALI), known a severe disease along with high morbidity and mortality, is lacking of specific therapies. Inflammation, apoptosis and oxidative stress are critical pathologies that contribute to ALI. Recently, there is study indicated that NLRP9b, a NOD-like receptor (NLR) member, is critical in modulation of inflammatory response. However, the effects of NLRP9b on sepsis-associated ALI, and the underlying molecular mechanism have not been understood. In the present study, the wild type (WT) and NLRP9b-knockout (NLRP9b-/-) mice with C57B/L6 background were subjected to a cecal ligation and puncture (CLP) for ALI murine model establishment. The findings indicated that NLRP9b-/- improved the survival rate of CLP-induced ALI mice, and inhibited pulmonary histopathological alterations, inflammation, and apoptosis. NLRP9b-/- reduced the activation of inhibitor of κBα/nuclear factor kappa B (IκBα/NF-κB), apoptosis-associated speck-like protein containing a Caspase-recruitment domain (ASC)/Casapse-1 and Caspase-3/poly (ADP-ribose) polymerase (PARP) signaling pathways in CLP-challenged mice with ALI. In vitro, mouse epithelial cells (MLE-12) were incubated with lipopolysaccharide (LPS) or recombinant NLRP9b caused a significant increased of pro-inflammatory cytokines or chemokine, and reactive oxygen species (ROS) generation; however, these changes were markedly alleviated by NLRP9-knockdown using its specific siRNA sequence. Pre-treatment of MLE-12 cells with ROS scavenger of N-acetylcysteine (NAC) remarkably decreased lipopolysaccharide (LPS)- and rMuNLRP9-induced production of ROS, and the secretion of inflammatory cytokines or chemokine, as well as the activity of IκBα/NF-κB, ASC/Casapse-1 and Caspase-3/PARP signaling pathways. Together, the findings here suggested that NLRP9b played an essential role in lung inflammation, apoptosis and oxidative stress of sepsis-induced ALI animal model or in LPS-induced MLE-12 cells, providing that NLRP9b inhibition might be a potential therapeutic option for ALI.

Research in rehabilitation and nursing care of myogenic fecal incontinence / 中国实用护理杂志

Objective To explore the methods and key points of nursing care for myogenic fecal incontinence.Methods There were 65 patients with myogenic fecal incontinence in this study.All these patients had undergone sphincter reconstruction surgery.Holistic nursing and biofeedback training were provided for all these patients after surgery.Results The complications in these patients included diaper rash of 32 cases,perianal ulcer 12 cases,urinary infection 7 cases,postoperative wound infection 16 cases.After treatment and holistic care,all the diaper rash disappeared and all the peroanal ulcer healed.The urinary infection for those 7 patients were controlled.Fifteen postoperative wound infection were cured,and one recovered after intestinal fistula.Six months to two years follow-up revealed that the clinical score after treatment was significantly higher than that before treatment (1.72±0.22 vs 4.01±0.36).Conclusions Enema,holistic nursing care and rehabilitation training are important for rehabilitation of myogenic fecal incontinence.

Efficiency of overflow fecal incontinence treated by biofeedback and electrical-stimulating therapy / 中国现代普通外科进展

Objective: To investigate the shortterm efficiency of overflow fecal incontinence treated by biofeedback and electrical stimulating therapy. Methods: Twenty children with overflow fecal incontinence were given combined therapy, biofeedback and electricalstimulating therapy,for four weeks. Every therapy cost 20 to 30 minutes. The grading of clinical incontinence degree ,measurement of pressure of the anus and rectum, electromyogram of muscles of solum plevis were done before and after the therapy. Results: Followup was done for a mean of 4.5 years (range 3 to 5), the subjective scores, maximum contractive pressure of anus, last contractive time, rectal volume at sensory threshold, contraction amplitude of external anal sphincter and pudenda neural latency were significantly different from the ones before treatment (P

Biofeedback therapy combinell with electrical stimulation in the treatment of traumatic faecal incontinence / 中华物理医学与康复杂志

Objective To observe the effect of biofeedback therapy combined with electrical stimulation in patients with traumatic faecal incontinence.Methods Eishty-two patients with traumatic faecal incontinence were treated once daily with electric stimulation delivered via an intra-anal electrode.They also followed a biofeedback regimen including strengthening,sensory and coordination biofeedback.The whole progrtun consisted of 3 sessions of supervised treatment in hospital followed by 3 sessions of home therapy(10 days per session with an interval of 7days between the sessions).Clinical scores and anorectal function were assessed before and after the program.Results Before treatment,there were 9 patients with good clinical scores,and the general rate of fair and poor clinical scores Was 89%.After therapy,61 patients had good scores,and the general rate of fair and poor Was 26%.Anorectal squeeze pressure and sphincter electromyographic amplitude had improved significantly,the rectal sensory threshold Was decreased significantly,and 76%of the patients who had no external anal sphincter reflex recovered.At the two years follow-up,68% of the patients had maintained the clinical outcomes.Conclusion Biofeedback therapy in conjunction with electrical stimulation has significant therapeutic effects on patients with traumatic faecal incontinence.

Recent outcome of bladder augmentation using deepithelialiezed segment of small intestine lined with urothelium / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate urodynamically and clinically bladder augmentation using double-deepithelialized segment of the small intestine lined with urothelium to analyse the recent outcome to treatment of hyperreflexia neurogenical bladder.</p><p><b>METHODS</b>25 patients with neurogenical bladder underwent bladder augmentation using deepithelialized segment of the small intestine lined with urothelium (4 - 14 years old, 16 males and 9 females) from October 1998 to October 2000. 21 patients were followed up. Voiding cystoureterography and urodynamic and clinical evaluation were performed, and serum electrolyte, urea nitrogen and creatinine were tested before and 6 months to 2 years after operation.</p><p><b>RESULTS</b>After operation, bladder volume, maximum urine flow rate and compliance were increased, but residual urine/bladder volume and detrusor pressure decreased. Uninhibitory contraction decreased in 15 patients. In 12 patients associated vesicoureteral reflux, clinical evaluation revealed poor outcomes before operation, but excellent (4 patients), good (9), effective (4), poor outcomes (4) after operation. Seven patients had urinary sensation recovered. Vesicoureteral reflux decreased in 9 patients. There were no electrolyte unbalance and abnormal renal function in all patients.</p><p><b>CONCLUSIONS</b>Bladder augmentation using double-deepithelialized segment of the small intestine lined with urothelium shows a better result currently.</p>

Biofeedback therapy for myogenic fecal incontinence / 中国普通外科杂志

Objective To evaluate the effect of biofeedback therapy for the treatment of myogenic fecal incontinence. MethodsA general assessment about anorectal function was made on 17 cases receiving biofeedback therapy including muscle power training,sensory training and coordination training. Results The clinical scores before and after biofeedback therapy were 1.66?0.23,3.80?0.42 respectively,with an effective rate of 82%. The anus maximum contracting pressure elevated,(73?20) mm Hg vs. (123?30) mm Hg; myoelectric amplitude increased,(122?32) ?V vs. (230?41) ?V;Contracting time prolonged,(4.1?2.0) s vs. (9.4?3.0) s; The sensory threshold was lowered,(50?12) ml vs. ( 20? 10) ml;The feel-contract time increased,(3.1?0.4) s vs. (1.2?0.3) s. Positive rectal contraction reflex was seen in 41% patients before therapy compared with 82% after therapy. Conclusions Biofeedback therapy increases contractility of sphincter,decreases threshold of rectal sensory,and is a therapy of choice for myogenic fecal incontinence.

The influence of neurogenic anorectum to the function of anorectum / 中国现代普通外科进展

Objective:To study the influence of neurogenic anorectum induced by myelodysplasia on function of anorectum.Methods:Twenty-five patients with myelodysplasia were evaluated by anorectal manometry.The function of anal sphincter was evaluated by resting pressure,contractive pressure and the length of high pressure;The sensation of rectum was evaluated by rectal maximum volume threshold;The function of defecation reflex was evaluated by rectoanal inhibitory reflex.Results:Anal resting pressure in the children with neurogenic anorectum induced by myelodysplasia( 25.8?3.4)mmHg was lower than that in normal children(66.7?24)mmHg.The maximum contractive pressure of anus in patients (86.6?20.1)mmHg was lower than that in normal children(129.0?18.8)mmHg.The length of high pressure in patients (17.5?4.5)mm was lower than that in normal children(23.6?4.6)mm.The rectal volume at sensory threshold in patients(62.1?8.5)ml was higher than that in normal children(36.0?12.6)ml.Rectal maximum volume threshold in patients(141.4?22.6)ml was higher than that in normal children (109.5?12.2)ml.Rectoanal inhibitory reflex was identified in both patients and normal children.Conclusions:Anorectal manometry may provide objective assessment of the neurogenic damage of anorectum in myelodysplasia including the damage of sphincter and the decrease of the rectal sensation. Rectoanal inhibitory reflex was identified in both patients and normal children. The major objective of anorectal treatment for patients with myelodysplasia was to strengthen the function of external sphincter, internal sphincter and pelvis floor muscle and to repair the sensation of rectum.