Early experience of the compression anastomosis ring (CAR^(TM) 27) in left-sided colon resection

AIM:To evaluate clinical validity of the compression anastomosis ring(CARTM27) anastomosis in left-sided colonic resection. METHODS:A non-randomized prospective data collection was performed for patients undergoing an elective left-sided colon resection,followed by an anastomosis using the CARTM27 between November 2009 and January 2011.Eligibility criteria of the use of the CARTM27 were anastomoses between the colon and at or above the intraperitoneal rectum.The primary short-term clinical endpoint,rate of anastomotic leakage,and other clinical outcomes,including intraand postoperative complications,length of operation time and hospital stay,and the ring elimination time were evaluated. RESULTS:A total of 79 patients(male,43;median age,64 years) underwent an elective left-sided colon resection,followed by an anastomosis using theCARTM27.Colectomy was performed laparoscopically in 70 patients,in whom two patients converted to open procedure(2.9%) .There was no surgical mortality.As an intraoperative complication,total disruption of the anastomosis occurred by premature enforced tension on the proximal segment of the anastomosis in one patient.The ring was removed and another new CARTM27 anastomosis was constructed.One patient with sigmoid colon cancer showed postoperative anastomotic leakage after 6 d postoperatively and temporary diverting ileostomy was performed.Exact date of expulsion of the ring could not be recorded because most patients were not aware that the ring had been expelled.No patients manifested clinical symptoms of anastomotic stricture. CONCLUSION:Short-term evaluation of the CARTM27 anastomosis in elective left colectomy suggested it to be a safe and efficacious alternative to the standard hand-sewn or stapling technique.

Why hypertension is good new and preeclampsia bad news-demonstrating the failure of prevention

Hypertensive disorders in pregnancy continue to be an intriguing and potentially lethal complication in humans and some other primates. In a simplistic way the current hypothesis is that the genesis of preeclampsia starts at 12 to 14 wk gestation with failure of trophoblast invasion in the spiral arteries, resulting in some degree of hypoxemia in the placenta. The hypoperfused placental tissue starts to secrete variable amounts of angiogenic and antiangiogenic factors which eventually cause endothelial damage all over the pregnant women's body with one of the many signs of preeclampsia as the clinical endpoint. For some incomprehensible reason a major interest has existed for decades concerning the early prediction of preeclampsia, most commonly tested using uterine artery Doppler(the earlier the better) and various serum markers, alone or in combination. Any new model for detection has been welcomed enthusiastically, although nothing has changed in the outcome of women presenting with preeclampsia.

EFFECT OF THIRD TRIMESTER OF PREGNANCYON DIURNAL VARIATION OF OCULAR PRESSURE

This study was planned to evaluate the effect of pregnancy on diurnal variation of intraocular pressure(IOP) after placing control on all the IOP affecting factors. The IOP was measured with the Goldmann ap-planation tonometer. Both in the control and 3rd trimester subjects, the peak of mean IOP appeared in themorning when the subJects waked, and the trough of mean IOP happened at 2 am to 4 am. The diurnal in-traocular pressure curves revealed that the lOP peaks were 15.4±0. 9 and 12. 9±0. 6 mmHg in the controland third trimester pregnant subjects, respectively. Whereas the trough were 13.1±0. 4 and 11. 8±0. 3mmHg, respectively. The mean diurnal variation were 2. 3±0. 6 mmHg (P<O.01 ), and 1.1±0. 8mmHg in the control and third trimester subjects, respectively. There are two main findings of presentstudy: first, compared with non-pregnant control subjects, the IOP was significantly lower (P<0.001 ) inthe third trimester pregnant subjects. Second, in the third trimester of pregnancy, the lower IOP level wasassociated with the less degree of IOP fluctuations at various hours of the day.

670份新型冠状病毒肺炎康复者恢复期血浆检测结果分析

目的对670份新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)康复者恢复期血浆(convalescent plasma,CP)检测结果进行分析评价。方法分别从血浆常规检测项目[乙型肝炎病毒表面抗原(HBsAg)、丙型肝炎病毒(HCV)抗体、人类免疫缺陷病毒(HIV-1/HIV-2)抗体、梅毒螺旋体(TP)抗体、丙氨酸氨基转移酶(ALT)]、血型、新型冠状病毒(severe acute respiratory syndrome coronavirus 2,SARS-CoV-2)核酸检测、IgG抗体检测、亚甲蓝残留以及无菌检查等项目展开分析评价。结果670份COVID-19康复者恢复期血浆共检出121份不合格血浆,IgG抗体滴度不合格占比最高,检出率7.91%。血型分布占比为A(32.52%)>B(29.94%)>O(28.886%)>AB(8.66%)。SARSCoV-2核酸检测均为阴性。485份血浆来自武汉,其中>30~35年龄段占比最高(21.95%),男性264人,女性221人;高滴度血浆中IgG抗体≥1∶640占比最高,为77.43%。普通型患者在压床期>10~20 d中IgG抗体≥1∶640的比例最高,在压床期3~10 d中,IgG抗体<1∶160比例最高。IgG抗体(<1∶80)阴性血浆35份,其中9份检出其他病原体。结论IgG抗体不达标是康复者血浆不合格的主要因素。COVID-19康复者恢复期血浆O型血占比低于正常人群分布比例。武汉市献浆人群年龄层占比最高集中在>30~35岁,男性比例高于女性。大多数康复期患者体内针对SARS-CoV-2产生了良好的免疫应答,可有效清除体内病毒。普通型患者在压床期>10~20 d产生较高的抗体滴度,不容易转为重型。推测IgG抗体阴性患者可能存在合并其他病原体感染。

Participation of clinical pharmacist specialized in oncology in the treatment of a patient with advanced esophageal carcinoma complicated with hypertension: one case report

Clinical pharmacists specialized in oncology contributed to the safe and effective chemotherapy treatment for advanced esophageal carcinoma patients complicated with hypertension by participating in medication practice. Optimal therapeutic regimen was proposed, and pharmaceutical care and health education were provided based on the condition of each patient. By providing pharmaceutical care for cancer patients with their pharmacy knowledge, clinical pharmacists specialized in oncology can not only reduce the potential risks of chemotherapy, but also take into account of other accompanying diseases, thus improving the comprehensive treatment of patients. Furthermore, it deepened the understanding of the role of clinical pharmacy practice by patients and other medical workers. Involvement of clinical pharmacist in therapeutic practice could improve the outcome of pharmacotherapy.

Effect of Yinian Jiangya Yin on Primary Hypertension in Early Stage—A Clinical Observations on 40 Patients

Objective: To observe the effect of Yinian Jiangya Yin (Decoction for lowering blood pressure to prolong life) on patients with early hypertension and its mechanism on the function of vascular endotheliocytes. Methods: The 79 patients with early primary hypertension belonging to the TCM syndrome of stagnation of phlegm and blood stasis in meridians and hyperactivity of the liver-yang were randomly divided into a treatment group of 40 patients treated with Yinian Jiangya Yin and a control group of 39 patients treated with Tianma Gouteng Yin (Decoction of Gastrodia and Uncaria). The changes in score of TCM syndrome and in blood pressure before and after treatment were observed in the two groups. The contents of nitrogen monoxide (NO) and endothelin (ET) in serum after treatment were determined. Results: There was a statistical difference (P<0.05) in score of TCM syndrome, effect of lowering blood pressure, and the contents of ET and NO in serum after treatment between the two groups. Conclusion: The effect of Yinian Jiangya Yin on improving TCM syndrome of patients with primary hypertension in early stage and on lowering blood pressure may be related to its regulating the imbalanced condition between ET and NO for restoring the function of endothelium-dependent vasodilation.