AIM: To assess the efficacy and safety of diverting colostomy in treating severe hemorrhagic chronic radiation proctitis(CRP). METHODS: Patients with severe hemorrhagic CRP who were admitted from 2008 to 2014 were enr...AIM: To assess the efficacy and safety of diverting colostomy in treating severe hemorrhagic chronic radiation proctitis(CRP). METHODS: Patients with severe hemorrhagic CRP who were admitted from 2008 to 2014 were enrolled into this study. All CRP patients were diagnosed by a combination of pelvic radiation history, clinical rectal bleeding, and endoscopic findings. Inclusion criteria were CRP patients with refractory bleeding with moderate to severe anemia with a hemoglobin level < 90 g/L. The study group included patients who were treated by diverting colostomy, while the control group included patients who received conservative treatment. The remission of bleeding was defined as complete cessation or only occasional bleeding that needed no further treatment. The primary outcome was bleeding remission at 6 mo after treatment. Quality of life beforetreatment and at follow-up was evaluated according to EORTC QLQ C30. Severe CRP complications were recorded during follow-up.RESULTS: Forty-seven consecutive patients were enrolled, including 22 in the colostomy group and 27 in the conservative treatment group. When compared to conservative treatment, colostomy obtained a higher rate of bleeding remission(94% vs 12%), especially in control of transfusion-dependent bleeding(100% vs 0%), and offered a better control of refractory perianal pain(100% vs 0%), and a lower score of bleeding(P < 0.001) at 6 mo after treatment. At 1 year after treatment, colostomy achieved better remission of both moderate bleeding(100% vs 21.5%, P = 0.002) and severe bleeding(100% vs 0%, P < 0.001), obtained a lower score of bleeding(0.8 vs 2.0, P < 0.001), and achieved obvious elevated hemoglobin levels(P = 0.003), when compared to the conservative treatment group. The quality of life dramatically improved after colostomy, which included global health, function, and symptoms, but it was not improved in the control group. Pathological evaluation after colostomy found diffused chronic inflammation cells, and massive fibrosis collagen depositio展开更多
This tomb is a large-sized wooden-chamber pit at Xucungang, Zhulin township, Qixian county, Henan province. It has an earth-rammed mound at the top and a sloping tomb-passage at the southern end. In the pit is a circl...This tomb is a large-sized wooden-chamber pit at Xucungang, Zhulin township, Qixian county, Henan province. It has an earth-rammed mound at the top and a sloping tomb-passage at the southern end. In the pit is a circle of stone wall, the gap outside which is filled with charcoal, and the tomb bottom is covered with stoneslabs. The room within the walls is divided into two parts: the frontal for funeral objects and the rear for a wooden chamber and the coffin it encases. The chamber is triplex, built of narrow blocks of wood; the coffin, double, with the boards mortised together. Of the funeral objects, despite serious robbery, there remain jades, bronzes, irons, lacquered articles, and a number of “wu zhu” coins.Judging from the characteristic features of the tomb shape and grave goods, the tomb can be dated to the late Western Han period.展开更多
基金Supported by National Natural Science Foundation of China,No.81201581,No.81573078 and No.81372566Support Program from Ministry of Science and Technology of China,No.2014BAI09B06Natural Science Foundation of Guangdong Province,China,No.2016A030311021
文摘AIM: To assess the efficacy and safety of diverting colostomy in treating severe hemorrhagic chronic radiation proctitis(CRP). METHODS: Patients with severe hemorrhagic CRP who were admitted from 2008 to 2014 were enrolled into this study. All CRP patients were diagnosed by a combination of pelvic radiation history, clinical rectal bleeding, and endoscopic findings. Inclusion criteria were CRP patients with refractory bleeding with moderate to severe anemia with a hemoglobin level < 90 g/L. The study group included patients who were treated by diverting colostomy, while the control group included patients who received conservative treatment. The remission of bleeding was defined as complete cessation or only occasional bleeding that needed no further treatment. The primary outcome was bleeding remission at 6 mo after treatment. Quality of life beforetreatment and at follow-up was evaluated according to EORTC QLQ C30. Severe CRP complications were recorded during follow-up.RESULTS: Forty-seven consecutive patients were enrolled, including 22 in the colostomy group and 27 in the conservative treatment group. When compared to conservative treatment, colostomy obtained a higher rate of bleeding remission(94% vs 12%), especially in control of transfusion-dependent bleeding(100% vs 0%), and offered a better control of refractory perianal pain(100% vs 0%), and a lower score of bleeding(P < 0.001) at 6 mo after treatment. At 1 year after treatment, colostomy achieved better remission of both moderate bleeding(100% vs 21.5%, P = 0.002) and severe bleeding(100% vs 0%, P < 0.001), obtained a lower score of bleeding(0.8 vs 2.0, P < 0.001), and achieved obvious elevated hemoglobin levels(P = 0.003), when compared to the conservative treatment group. The quality of life dramatically improved after colostomy, which included global health, function, and symptoms, but it was not improved in the control group. Pathological evaluation after colostomy found diffused chronic inflammation cells, and massive fibrosis collagen depositio
文摘This tomb is a large-sized wooden-chamber pit at Xucungang, Zhulin township, Qixian county, Henan province. It has an earth-rammed mound at the top and a sloping tomb-passage at the southern end. In the pit is a circle of stone wall, the gap outside which is filled with charcoal, and the tomb bottom is covered with stoneslabs. The room within the walls is divided into two parts: the frontal for funeral objects and the rear for a wooden chamber and the coffin it encases. The chamber is triplex, built of narrow blocks of wood; the coffin, double, with the boards mortised together. Of the funeral objects, despite serious robbery, there remain jades, bronzes, irons, lacquered articles, and a number of “wu zhu” coins.Judging from the characteristic features of the tomb shape and grave goods, the tomb can be dated to the late Western Han period.
