Objective To study the influence of partial internal sphincterotomy on the postoperative pain after cutting seton treatment in patients with perianal infection. Methods A controlled study was carried out on 40 cases of cutting seton insertion with (Group A) or without (Group B) partial internal sphincterotomy. The subjects reported their postoperative pain at defecation and at rest respectively using a visual analogue scale (VAS). The intensity of pain between the two groups was compared. Results All the 40 patients were cured, without recurrence or fecal incontinence. During the period of cutting seton treatment, the pain scores at defecation and at rest were lower in the Group A than in the Group B ( P 0.05). Conclusions Internal sphincterotomy can significantly relieve anal pain after cutting seton treatment, being an effective method.

Objective To analyze the correlation of acute pancreatitis with hyperlipemia and C reactive pro-tein. Methods 42 patients with acute pancreatitis with hyperlipemia were divided into two groups of SAP group and MAP group under the diagnostic code. The blood fat and CRP were compared between the two groups, also the scores of APACHE Ⅱ , Ranson and CT were measured. Results The CRP and TG in group SAP compared with those in group MAP had significant difference(P<0.01),but the CHOL has no-difference;the scores of APACHEⅡ , Ranson and CT after control lipid in 42 patients were significantly' different( P < 0.05). Conclusion Hyperlipe-mia is one risk factors of the AP;combined with the CRP, it can be one evaluating index of the severity.

Objective To study the character of cervical lymph nodes metastasis in nasopharyngeal carcinoma(NPC) by contrast-enhanced uhrasonography(CEUS) and time-intensity curve. Methods Forty-one lymph nodes of metastasis from 32 patients were studied by CEUS. The enhancement of echogenicity was evaluated,and the time-intensity curve was analyzed. Results Of the 41 lymph nodes examined, 10 (24.4%) showed intense homogeneous enhancement by CEUS, 23 (56.1%) showed inhomogeneous enhancement and 8 (19.5 %) showed scarce intranodal enhancement. There were 20 (48.8%) lymph nodes showed necrosis. Most of the lymph nodes (92.7%) showed peripheral type blood flow, 3 (7.3) % showed mixed type blood flow. There were significant differences in them(P < 0.01). The time-intensity curve displayed steeply in upslope, and gently in decent. The arrival time(AT), time to peak(TTP), peak intensity (PI) ,area and gradient were (7.2±2.5)s,(7.6±2.3)s,(9.5±3.3)dB,(203.4±45.7)dB· s,1.2±0.5 respectively. Between the lymph nodes with envelope infringed and not, there were significant differences in PI and area, while there were not significant differences in AT, TTP and gradient. Conclusions The metastasis cervical lymph nodes of NPC had specific character by CEUS and time-intensity curve. In this way,it may help us to diagnosis cervical lymph nodes metastasis of NPC,and provide more information for the therapy and prognosis judgement.

Objective To assess the value of blood perfusion of thyroid nodules using contrastenhanced ultrasonography(CEUS). Methods Blood perfusion parameters of 78 preoperative patients with thyroid nodule were examined using CEUS. Microvessel density(MVD) in the thyroid nodule specimens was calculated by immunohistochemical staining using anti-factor CD34. Results Compared to papillary thyroid carcinoma (PTC) and nodular goiter (NG), there was significant differences in peak value(PEAK),maximum value of video signal intensity(Slmax), and mean value of video signal intensity(SImean) in thyroid nodule with diameter ＜ 1 cm ( P ＜ 0. 05 ), the MVD of thyroid nodules was not statistically significant ( P ＞ 0.05). There were significant differences in regional blood volume and MVD in thyroid nodule with diameter ≥ 1 cm between two groups ( P ＜ 0.05). Conclusions The characteristics of blood perfusion are dissimilar for thyroid nodules with different sizes and properties. The quantitative analysis with CEUS can provide valuable information for clinical diagnosis.

Objective To explore the feasibility and efficacy of the selective portal vein embolization (SPVE) before radiofrequency ablation(RFA) for liver tumor large than 3 cm.Methods 63 patients with 63 liver tumor (＞3 cm) located in single liver segment completely or mostly underwent RFA.21 patients (21 lesions) were randomly assigned to receive SPVE before ablation (SPVE + RFA group),other 42 patients were treated with RFA only (RFA group).The complications and treat results of two groups were collected and compared.Results SPVE were achieved in 20 of 21 patients,and no critical complication were happened in both group.During a observation period of median 14.2 months,local tumor progression were observed in 17 of 42 patients (40.5％) in RFA group and in 3 of 20 patients (15.0％) in SPVE+ RFA group,there were significant difference between two groups(P =0.043).Conclusions SPVE can safely and effectively improve the efficacy of RFA for the liver tumors which large than 3 cm and located in single liver segment.

Melioidosis is a endemic infectious disease caused by Burkholderia pseudomallei, and is considered one of the major causes of fatal pneumonia and sepsis.This paper reports diagnosis and treatment course of one case pulmonary melioidosis, and reviews the related literatures, so to improve clinical workers'' understanding towards melioidosis, avoid misdiagnosis and missed diagnosis.

Objective To evaluate the clinical efficacy of arthroscopic treatment of tibial intercondylar eminence avulsion fracture in pediatric patients without epiphyseal interference.Methods From February 2010 to February 2014,18 children patients with avulsion fracture of tibial eminence were admitted.They were 12 boys and 6 girls,from 7 to 14 years of age (average,10.4 years).Four cases were complicated with meniscus injury and 2 with medial collateral ligament injury.The mean time from injury to surgery was 4.5 days (range,from 2 to 7 days).According to Meyers-McKeever classification,13 children were type Ⅱ and 5 type Ⅲ.They were treated with Ultrabraid sutures arthroscopically.After reposition,the bone fragments were fixated to the distal epiphysis of tibial tubercle through the inferior of transverse ligament of knee to avoid epiphyseal injury.Anterior drawer test,Lanchman test,pivot shift test and Lysholm knee scoring were conducted at all clinical follow-up visits to assess functional recovery.Results All children were followed up from 10 to 24 months (average,15 months).The X-ray examination demonstrated bone union in all cases.At the end of follow-up,all children achieved satisfactory recovery of range of motion without complications like joint stiffness,joint relaxation,dysfunction or epiphyseal injury.The anterior drawer test,Lanchman test and pivot shift test were all negative at the last follow-up.The mean Lysholm knee scores improved significantly from preoperative 45.6 ± 7.4 to 92.4 ± 5.8 at the final follow-up (t =-25.403,P ＜ 0.01).Conclusions Bone reposition under arthroscopy with suture fixation is reliable and minimally invasive in the treatment of avulsion fractures of tibial intercondylar eminence in pediatric patients.

Objective To investigate the application value of CT venography(CTV) in the diagnosis and treatment of Budd‐Chiari syndrome(BCS) .Methods 58 patients with BBCS in our hospital from January 2012 to January 2014 were performed the CTV examination .The inferior vena cava ,hepatic vein ,portal vein and collateral vessels were performed the reconstruction analysis . Results All the patients were definitely diagnosed as BCS after completing CTV examination ,including :19 cases of inferior vena cava(IVC) diaphragm type ,15 cases of short IVC segment occlusion ,8 cases of long IVC segment occlusion ,9 cases of hepatic vein stenosis or occlusion ,7 cases complicated by fresh thrombosis .In addition ,the different degrees of compensatory expansion of col‐lateral vesse ,intuition and comprehensiveness ,can display the position ,character and length of lesion vessel ,also observes the de‐grees of collateral vessels expansion and liver cirrhosis .

Objective To investigate the effect of oncolytic adenovirus vector SG600-IL24expressing human melanoma differentiation associated gene-7 (mda-7/IL-24) on hepatocellular carcinoma cell lines with different metastatic potential of HepG2, SMMC7721, MHCC97L and normal liver cell line LO2. Methods The oncolytic adenovirus SG600-IL24 which carrying mda-7/IL-24 gene was transfected into hepatocellular carcinoma cell lines and normal liver cell line. The mRNA and protein expression of mda7/IL-24 in HepG2, SMMC7721, MHCC97L and LO2 cell lines was confirmed by RT-PCR,ELISA assay and Western blot respectively. MTT assay and flow cytometry were used to study tumor cell proliferation and cell cycle in vitro. Hoechst33258 and flow cytometry were studied to indicate the apoptosis effects. Results It was confirmed by RT-PCR, ELISA assay and Western-blot that the exogenous mda-7/IL-24 gene was highly expressed in HepG2, SMMC7721, MHCC97L and LO2 cell lines. MTT and apoptosis detection indicated that MDA-7/IL-24 can induce the growth suppression (the inhibition rate was 75% ±2. 5% ,86% ±3. 5% ,and promotes apoptosis ( the apoptosis rate was 56. 5% ± 4. 0% , 34. 4% ± 2. 0% , 43. 3% ± 2. 5%cell lines at G2/M phase ( the blocking rate was 35. 4% ± 4. 2% , 40. 5% ± 5. 0% , 42. 0% ± 5. 0%metastatic potential hepatocellular carcinoma cell lines but not in normal liver cell line.Conclusions Oncolytic adenovirus vector SG600-IL24 can selectively induce growth suppression, promote apoptosis in hepatocellular carcinoma lines in vitro but not in normal liver cell LO2.

Objective To assess the anal and pelvic floor function in patients with rectocele (RC),and to afford the evidence for the treatments of RC.Methods Patients with functional constipation (FC) and healthy controls were consecutively enrolled,and all the subjects underwent defecography and anorectal manometry.According to defecography,the subjects were divided into four groups as no RC,mild RC,moderate RC and severe RC.The t-test,analysis of variance,rank sum test and Chi-square test were performed to compare the results of anorectal manometry between different RC groups in FC patients,and the results of anorectal manometry between moderate RC group in FC patients and control group with moderate RC were also compared.Results A total of 54 FC patients and 17 healthy controls were enrolled.No RC was found in all of male subjects.Of 48 female patients with FC,nine cases (18.8％) had no RC,seven (14.6％) had mild RC,18(37.5％) had moderate RC,and 14(29.2％) had severe RC.Three of the 12 female controls had no RC,one had mild RC,and eight had severe RC.Among all female patients with FC,the defecation rectal pressure in severe RC group ((34.4 ± 14.2) mmHg,1 mmHg=0.133 kPa) was significantly higher than of no RC group ((20.8 ± 13.1) mmHg,t=3.663,P=0.001),mild RC group ((19.1± 15.1) mmHg,t=3.719,P＜0.01) and moderateRC group ((25.6±16.3) mmHg,t=2.525,P=0.010).The left rectal pressure after defecation in mild RC group ((55.1 ± 19.7) mmHg) was significantly higher than that of moderate RC group ((43.3±17.6) mmHg,t=2.507,P=0.019) and severe RC group ((40.0±20.9) mmHg,t=2.619,P=0.006).The anal relax ratio in mild RC group (3.0％,0.5％ to 25.5％) was significantly lower than that of moderate RC group (19.5％,10.0％ to 29.0％,Z=-2.583,P=0.010) and severe RC group (22.0％,7.3％ to 54.5％,Z=-2.830,P=0.005).There were no significant differences in rectal and anal resting pressure,anal squeezing pressure,rectal sensory threshold and constituent ratio of manometry among four groups (all P＞0.05).The left rectal pressure after defecation in FC patients with moderate RC ((43.3 ± 17.6) mmHg) was significantly higher than that of controls with moderate RC ((26.3±20.8) mmHg,t=2.997,P＜0.01),and anal relax ratio was significantly lower than that of controls with moderateRC ((23.4±20.2)％ vs (55.2±16.3)％,t=-5.266,P=0.008).Conclusions RC is found in female and also found in individuals with normal defecation.FC patients with mild RC lack enough anal relax during defecation.However,defecation is relatively coordinate in FC patients with severe RC,which indicates that severe RC may be part of manifestation of pelvic floor relaxation.