Search

CLINICAL STUDY ON ANORECTAL MANOMETRY

Objective To evaluate the clinical appliance and significance of the technique of anorectal manometry. Methdos Different ways of anorectal manometry, domain of its appliance and its clinical appliance was summarized and reviewed. Results The technique of anorectal manometry not only has important value on the study of analrectal pathology and physiology, but also can be associated with other examinations to manage biofeedback therapy, diagnose all kinds of anorectal diseases and evaluate anorectal function. Conclusion Anorectal manometry is a safe, simple, harmless and impersonal examination technique. It is necessary in the examination of analrectal function, in the diagnosis and treatment of anolrectal diseases.

孕婦補充維生素A 對子女肺功能的影響（Maternal vitamin A supplementation and lung function in offspring）

孕婦補充維生素A 對子女肺功能的影響（Maternal vitamin A supplementation and lung function in offspring） 【摘要翻譯】 背景: 維生素A 在肺早期發育和肺泡形成中發揮重要的調節作用。孕婦維生素A 的水平可能是影響胚胎肺泡形成的一個重要因素, 孕婦維生素A 缺乏對其子女肺健康具有不利影響。為驗證這一假設, 我們在一個長期維生素A 缺乏的人群中的婦女中研究了孕前、孕中及孕后補充維生素A 或β胡蘿卜素對子女肺功能的遠期影響。方法: 我們檢查了尼泊爾農村9 ～13 歲的兒童, 這些兒童的母親在1994 年至1997 年參加了一個補充維生素A 或β胡蘿卜素、安慰劑對照、雙盲組群隨機抽樣試驗。結果: 在原試驗結束時有1894 例兒童存活, 其中1685 例( 88% ) 符合納入標準參加本研究進行隨訪。其中1371 例兒童( 納入試驗兒童的83% ) 在2006 年10 月至2008 年3 月期間進行了肺功能測定。在校正身高、性別、年齡、體重指數、歷月、種族及肺功能儀等因素后, 母親服用維生素A 的兒童FEV1 和FVC 均顯著高于母親服用安慰劑的兒童( FEV1 : 維生素組高46 mL,95% CI 6 ～86; FVC: 維生素組高46 mL, 95% CI 8 ～84) 。而服用β胡蘿卜素的研究對象肺功能與安慰劑組相似( FEV1 :β胡蘿卜素組高14 mL, 95% CI 24 ～54; FVC: β胡蘿卜素組高17 mL, 95% CI 21 ～55) 。結論: 在長期營養不良的人群中, 孕前、孕中及孕后在孕婦食物中補充適當的維生素A 能改善其子女肺功能。這種改善帶來的公共衛生的益處在兒童青春期前是明顯的。 【述評】 維生素A 通過調節細胞的增殖和分化影響身體發育生長。動物實驗證實維生素A 缺乏會可導致肺發育不良。本研究通過嚴格的臨床科研設計證實在維生素A 缺乏的母親中補充維生素A 可增加其子女FEV1 和FVC, 進一步表明維生素A 在肺發育中的重要作用。但是, 這種維生素A 補充對肺功能的遠期影響, 包括成人后肺功能情況及老年后肺功能的減退的影響值得進一步研究。其次, 這種肺功能改善對兒童及成人呼吸系統疾病, 包括哮喘、COPD、支氣管擴張癥等的發生是否具有影響也值得探討。最后, 應進一步研究這種維生素A 補充與肺功能改善是否存在量效關系, 以提供最佳的補充劑量。

腹部外科急癥1385例救治分析

Clinical Analysis of Laparoscopic Cholecystectomy Under Lower Pneumoperitoneal Pressure for Patient with Cardiofunction Ⅱ (Report of 18 Cases

【摘要】目的 探討心功能Ⅱ級患者在低氣腹壓下行腹腔鏡膽囊切除術的可能性。 方法 總結我院2003年7月至2004年7月間收治的18例心功能Ⅱ級患者行低氣腹壓腹腔鏡膽囊切除術的臨床資料。 結果 18例心功能Ⅱ級患者中17例完成腹腔鏡膽囊切除，1例中轉開腹。 結論 心功能Ⅱ級患者行低氣腹壓腹腔鏡膽囊切除術是可行的。

Efficacy of Cognitive Behavioral Therapy on Mental Health and Social Function in Patients with Multiple Sclerosis: A Meta-analysis

ObjectiveTo systematically review the efficacy of cognitive behavioral therapy (CBT) for improving mental health and social functions in patients with multiple sclerosis (MS). MethodsWe searched PubMed, EMbase, The Cochrane Library (Issue 4, 2016), CBM and CNKI from inception to May 2016, to collect randomized controlled trials (RCT) about CBT on mental health and social function in patients with MS. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then meta-analysis was performed by using RevMan 5.3 software. ResultsA total of 11 RCTs involving 1 102 patients were included. The results of meta-analysis showed that, the HADS scores (depression: MD=-1.28, 95%CI-2.07 to-0.48, P=0.002; anxiety: MD=-1.52, 95%CI-2.99 to-0.06, P=0.04), BDI scores (MD=-9.11, 95% CI-15.82 to-2.40, P=0.008), HRDS scores (MD=-7.23, 95% CI-13.65 to-0.82, P=0.03), Chalder scores (MD=-4.88, 95% CI-6.61 to-3.16, P < 0.000 01), MFIS scores (MD=-2.98, 95% CI-4.52 to-1.44, P=0.000 2) and GHQ-12 scores (MD=-3.61, 95%CI-5.20 to-2.02, P < 0.000 01) in the CBT group were lower than that in the control group. No significant difference was found in WSAS scores (MD=-1.98, 95%CI-4.88 to 0.93, P=0.18) between two groups. ConclusionCBT may be effective for improving the negative mental experience, fatigue and quality of life in MS. No evidence to support CBT has benefits in social functions. Due to the limited quantity and quality of the included studies, the above conclusion needs to be verified by more high quality studies.

The relationship between obesity and thyroid function

Obesity is closely related to thyroid function. The concentration of thyroid stimulating hormone (TSH) in obese patients is higher than that in the general population, and TSH will decrease accordingly after weight loss. Leptin is a bridge linking obesity and thyroid hormones, which can affect the release of TSH. There are many kinds of weight-reducing drugs that target the thyroid gland. Among them, thyroid hormone receptor-specific agonists may be potential drugs for future obesity treatment, but further studies are still needed.

Association of Lipoprotein Lipase Gene S447X Polymorphism and Cognitive Decline in Chinese Patients with Hypertension

摘要:目的:研究高血壓病患者脂蛋白脂肪酶(liportein lipase, LPL)S447X基因多態性與認知功能之間的關系。方法: 對2008年1月至2008年11月在四川大學華西醫院醫院門診就診的原發性高血壓患者190例,收集一般資料,采用國際通用的簡易智力狀況量表測驗認知功能,計算認知評分,用聚合酶鏈反應限制性片段長度多態性(PCRRFLP)技術測定LPL S447X基因多態性。同時測定膽固醇、甘油三酯、空腹血糖、空腹胰島素及餐后2h血糖、餐后2h胰島素水平。結果: 高血壓病患者認知功能正常組和認知功能障礙組組間LPLS447X基因的基因型和基因頻率差異均無統計學意義(Pgt;0.05), SS和SX頻率分別為92.6%、7.4%,S和X等位基因頻率分別為96.3%和3.7%。結論: LPLS447X 基因多態性可能與高血壓認知功能障礙無明顯相關性。Abstract: Objective:To study the relationship between liportein lipase(LPL) S447X polymorphism and cognitive function in patients with primary hypertension. Methods:One hundred and ninety hypertensive patients from January 2008 to November 2008 in West China Hospital of Si Chuan University. We collected the general data and applied the Mini Mental State Examination to test the cognitive function and computed score. PCRRELP method was used to analyze the LPL S447X gene polymorphism. Total cholesterol、triglyeride、fasting plasma glucose and postprandial blood sugar、fasting insulin and postprandial plasma insulin were collected. Results:In primary hypertensive patients, both of the genotype frequency and the allele frequency of the LPL S447X polymorphism were not different between the cognitive normal group and the cognitive impaired group (Pgt;0.05). SS genotype was present in 0926 of the population, SX genotype was present in 0.074 of the population. allele frequencies were 0.963 for S allele and 0.037 for X allele. Conclusion:This results suggest S447X polymorphism in LPL with primary hypertension may not be associated with cognitive impairment. And age and postprandial plasma insulin level are the risk factors of hypertensive cognitive impairment.

The Relationship between Apoptosis, NSE, and Neurological Impairment in Experimental Intracerebral Hemorrhage in Rats

目的：了解大鼠腦出血后血腫周圍組織細胞凋亡與神經元特異性烯醇化酶（NSE）的表達及大鼠神經功能缺損程度的關系。方法：用膠原酶注入到大鼠尾狀核的方法制作腦出血模型。將大鼠分為腦出血、假手術組、正常組3組。采用蘇木素伊紅(HE) 染色、NSE免疫組織化學染色及TUNEL分別觀察各組在腦出血后第6 h、12 h、24 h、48 h、72 h、5 d、7 d時血腫周圍NSE及TUNEL的表達。用Longa評分法評價大鼠神經功能缺損程度。結果：大鼠在膠原酶注入6 h后形成穩定的血腫，在造模24～48 h神經功能缺損程度最重；6 h即見到TUNEL陽性細胞的表達，在48 h最明顯；NSE從神經元中漏出彌散到細胞間隙也在48 h達高峰。結論：腦出血血腫周圍凋亡與神經功能缺損及NSE的變化有關，凋亡可能在腦出血的神經損傷中起重要的作用。

Relationship between subclinical hyperthyroidism and the incidence of coronary heart disease: a meta-analysis

Objectives To assess the relationship between subclinical hyperthyroidism and the incidence of coronary heart disease (CHD). Methods PubMed, EMbase, The Cochrane Library, Web of Science, CNKI, VIP, WanFang Data and CBM databases were searched for studies on the relationship between subclinical hyperthyroidism and the incidence of CHD from inception to October 2016. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then, meta-analysis was performed by using RevMan 5.3 and Stata 12.0 software. Results In total, 14 cohort studies were included. The results of meta-analysis showed that subclinical hyperthyroidism was associated with the incidence of coronary heart disease (RR=1.19, 95%CI 1.01 to 1.40, P=0.04) and all-cause mortality (RR=1.36, 95%CI 1.11 to 1.67, P=0.003). Conclusions Subclinical hyperthyroidism is associated with an increased risk of CHD and all-cause mortality. Due to the limitation of quality and quantity of the studies, the above conclusions are required to be verified by large-scale and high quality research.

Effect of transcranial ultrasound stimulation on upper limb function recovery and cortical excitability in patients with stroke

Objective To observe the effect of transcranial ultrasound stimulation (TUS) on the recovery of upper limb motor function in stroke patients and explore its mechanism. Methods The inpatients with ischemic stroke and hemiplegia admitted to the Department of Rehabilitation Medicine of the Second Affiliated Hospital of Xi’an Jiaotong University between November 2019 and December 2021were prospectively included. The patients were randomly divided into a true stimulation group and a false stimulation group. All patients received routine medication treatment and rehabilitation training, with a course of 2 weeks. The patients in the true stimulation group also received TUS, and the stimulation site and mode in the false stimulation group were the same as those in the true stimulation group, but the transducer was in a non working mode. The changes in upper limb function and motor cortex electrical activity before and after treatment were compared between two groups of patients. The Wolf Motor Function Test (WMFT), Jebsen Hand Function Test (JHFT), and Fugl-Meyer Assessment-Upper Extremities (FMA-UE) were used as indicators of upper limb motor function. The motor evoked potential (MEP) latency, resting motor threshold (RMT), cortical silent period (CSP), and central motor conduction time (CMCT) were used as indicators of cortical excitability. Results A total of 30 patients were included, with 15 in the true stimulation group and 15 in the false stimulation group. There was no statistically significant difference in age, gender, course of disease, lesion side, handedness, National Institute of Health Stroke Scale score, and Barthel Index between the two groups of patients (P>0.05). Before treatment, there was no statistically significant difference in WMFT score, JHFT time, and FMA-UE score between the two groups of patients (P>0.05). After treatment, the WMFT score and FMA-UE score of both groups of patients increased compared to before treatment within the group, while the JHFT time decreased compared to before treatment within the group (P<0.05). The improvement degree of WMFT score (19.2±8.0 vs. 11.8±5.5), JHFT time [(39.3±20.4) vs. (26.0±15.9) s], and FMA-UE score [14.0 (12.0, 16.0) vs. 8.0 (7.0, 9.0)] before and after treatment in the true stimulation group were better than those in the false stimulation group (P<0.05). Before treatment, there was no statistically significant difference in MEP latency, CSP, CMCT, and RMT between the two groups of patients (P>0.05). After treatment, the MEP latency, CSP, CMCT, and RMT of both groups of patients decreased compared to before treatment within the group (P<0.05). The degree of decrease in CSP [(33.5±12.3) vs. (18.5±5.5) ms], CMCT [3.5 (2.5, 5.8) vs. 1.8 (1.5, 3.4) ms], and RMT [(19.2±12.8)% vs. (8.8±8.7)%] in the true stimulation group before and after treatment were greater than those in the false stimulation group (P<0.05). There was no statistically significant difference in the degree of decrease in MEP latency between the two groups before and after treatment (P>0.05). Both groups of patients had no adverse reactions during the treatment period. Conclusion TUS applied to the primary motor cortex can help restore upper limb motor function in stroke patients, and the mechanism of action may be related to TUS enhancing cortical excitability in the affected brain.