Objective To investigate the anatomical mark of attachment edge in mesorectal tail and the effect of its morphologic distribution in performing total mesorectal excision (TME). Methods The gross specimens of 220 consecutive patients with the middle lower rectal cancer were collected by a group of surgeons.Patients were divided into two groups.①Group in saving sphincter. Ⅰa group, low anterior resection (LAR): 81 patients with lesions between 5 and 6 cm from the anal verge underwent LAR ; Ⅰb group, anterior resection (AR): 68 patients with lesions between 7 and 8 cm from the anal verge underwent AR.②Group in resecting sphincter. Abdominoperineal resection (APR): 71 patients with lesions between anal verge and 5 cm from the anal verge underwent APR. Results ①The circular edge of mesorectal tail is attached on rectal wall of 1 cm above anal hiatus of levators,which level parallels the lower margin of lower rectal cancer.In order to reset distal rectal wall of 2 and 3 cm,undergoing LAR must avoid injuring rectal wall when dissecting muscular vessel of rectum continue along the levators fascia to the anal hiatus.②The attachment morphology of mesorectal tail is a circular flake and not circular linear in shape. There are a little of fat tissue between posterior rectal wall and mesorectal tail,the length of its longitudinal attachment is (1.269?0.171) cm (81 cases in LAR group and 71 cases in APR gourp).Because the distal resective margin of rectum undergoing AR just locate in area of flake attachment of mesorectum, removing mesorectum around rectal wall must avoid injuring the rectal wall. Conclusion The mesorectal tail is a circular flake and attaches on rectal wall of 1.0 cm above anal hiatus of levatorani.Undergoing LAR or AR must avoid to injure rectal wall,which may result in leakage of anastomosis when removing mesorectal tissuce around distal rectal wall.

Recurrence and peritoneal metastases are the major factors for the survival of colorectal cancer. With the development in the theory and technique of intraperitoneal chemotherapy,it has become a indispensable adjuvant chemotherapy of the advanced colorectal cancer.

Vascular graft is an important component of vascular tissue engineering. In the past several decades, the scaffold materials for vascular tissue engineering have developed from simple natural materials to compound of degradable polymer and biological materials. Great progress has been made in material design and procossing. Electrospirming has been introduced to replace the manual processing. However, more work still needs to be done to make the method of design and processing more satisfactory. Main efforts should be put into the studies on improving the mechanical properties and biological functions of the scaffold materials.

Objective To investigate the incidence of the aspirin resistance in secondary prevention of cerebral infarction, and the relationship between the aspirin resistance and the cerebral infarction recurrence or other vascular events during the follow-up periods.Methods Aspirin were taken from the first day of admission in 600 patients with cerebral infarction.The platelet aggregation rate was measured after 7-10 days to screen the patients with aspirin resistance or aspirin sensitivity.All patients were followed up for 6 to 24 months and the cerebral infarction recurrence and other vascular events were recorded.Logistic regression model was used to estimate the risk factors of aspirin resistance, vascular events and prognosis.Results Of 600 patients, 150 (25.0% ) patients were resistant to aspirin and 450 (75.0% ) patients were sensitive to aspirin.The proportion of female and diabetes patients, and the level of low density lipoproteins (LDL) in the aspirin resistance group were higher than those in the aspirin sensitivity group.Diabetes (OR = 2.58, 95% CI 1.37-4.85, P=0.003) and high LDL level (OR = 1.89, 95% CI 1.21-2.93, P = 0.005 ) were independent risk factors of aspirin resistance.The incidence of cerebral infarction recurrence and myocardial infarction and all-cause mortality in the aspirin resistance group were all higher than those in the aspirin sensitivity group.Diabetes ( OR = 2.47, 95% CI 1.36-4.65, P = 0.003 ) , atherothrombosis cerebral infarction (OR = 2.13, 95% CI 1.24-3.95, P = 0.023) and aspirin resistance (OR = 3.86,95% CI 1.79-5.87, P = 0.002) were independent risk factors of vascular events during the following-up period.In the patients with aspirin resistance, the risk of the recurrence of vascular events increased 3.86 times.Conclusions The incidence of aspirin resistance is high in secondary prevention of cerebral infarction.Aspirin resistance is closely correlated with cerebral infarction recurrence and other vascular events.

Acupuncture Therapy ; Aged ; Aging ; Hair Color ; Humans ; Male

The World Health Organization (WHO) Western Pacific Region with an estimated 160 million chronic hepatitis B virus (HBV) carriers in 2007 bears a significant burden of HBV-related mortality and morbidity. Most Member States in the region have an estimated chronic HBV infection proportion of more than 8% in their adult population, which is the highest worldwide. The WHO Regional Office for the Western Pacific published the first Regional Plan for Hepatitis B Control in January 2003. This plan is updated periodically with a consistent ultimate goal of achieving a chronic HBV infection rate of less than 1% in the region.

Viral hepatitis is a statutorily notifiable disease in Hong Kong Special Administrative Region (SAR). The Central Notification Office of the Department of Health receives notifications with pre-defined case definitions. In July 2011, Hong Kong SAR was verified by the WHO Regional Office for the Western Pacific as having successfully achieved the goal of hepatitis B control.

Liver cancer was the third leading cause of cancer death in Hong Kong SAR in 2012, and evidence showed that 75–80% of liver cancer cases were related to chronic HBV infection. This report reviews the surveillance data of HBV infections in Hong Kong SAR from 1988 to 2014 and discusses the responses and existing gaps to achieve the WHO goal in the local context.

Objective To investigate the efficacy of laparoscopic radical resection for colorectal cancer. Methods From September 2000 to December 2004, 99 patients with colorectal cancer underwent laparoscopic radical resection (laparoscopic group) and 198 patients with colorectal cancer underwent open radical resection (open group) at the Union Hospital of Fujian Medical University. The differences in local recurrence and survival between the two groups were compared. The local recurrence of tumors and survival of patients in the two groups were calculated by the life-table method, and were compared by the Wilcoxon (Gehan) test, chi-square test and Fisher's exact test. The recurrence interval and survival time of the two groups were compared by non-parametric Wilcoxon rank sum test. Results The 2-and 3-year local recurrence rates in the laparoscopic group were both 3.0% and the overall local recurrence rate was 3.0% (3/99). The 2-and 3-year local recurrence rates in the open group were 2.6% and 4.0% , respectively, and the overall local recurrence rate was 3.5% (7/198), with no significant difference between the two groups (χ2 =0.002, P > 0. 05). The median survival time of patients with local recurrence was 15 months (range, 7-24 months) in the laparoscopic group and 11 months (range, 2-28 months) in the open group, with no significant difference between the groups (U = 15. 500, P >0. 05). The 1-year survival rate was 33.3% in the laparoscopic group and 42.9% in the open group. The 2-year survival rate was zero in the laparoscopic group and 42. 9% in the open group. There were no significant differences between the groups for the 1-and 2-year survival rates (χ2 =0.120, P>0.05). Conclusions The efficacy of laparoscopic radical resection for colorectal cancer is similar to that of open surgery. Laparoscopic radical resection for colorectal cancer is safe and feasible, and does not increase the recurrence rate of cancer.

Objectives To study the feasibility of total mesorectal excision (TME) by laparoscopy for rectal cancer.Methods The mesorectum in the resected samples and the number of lymph nodes resected were compared between laparoscopic (n=20) and open surgery group (n=20).Results ①The mesorecum of resected specimen was all complete in two groups. ②The lymph node yield (N 1) in laparoscopic and open group was 8.5?3.6 vs. 10.6?6.2(P=0.334), respectively. That in N 2 was 3.7?2.2 vs. 2.4?2.1(P=0.328). That in N 3 was 2.4?1.7 vs. 2.0?1.8(P=0.590).③The distal margin was all tumor-free in the two groups. ConclusionLaparoscopy is capable of performing TME in patients with rectal carcinoma undergoing radical resection.

Acupuncture Therapy ; Adult ; Aged ; Female ; Hiccup ; physiopathology ; therapy ; Humans ; Intestines ; physiopathology ; Male ; Middle Aged ; Qi ; Stomach ; physiopathology ; Young Adult

Objective To observe the relations of sleep structure changes and cognitive behavior abnormalities in children with idiopathic epilepsy.Methods All night polysomnographies, day attention test and Achenbach child behavior checklist were done on 64 children with idiopathic epilepsy and 20 healthy controls the requirement. Spearman correlations were made to evaluate the correlations between the parameters of sleep structure and the results of attention and cognitive behavior abnormalities.Results All children with epilepsy had longer stage Ⅰ sleep percentage and latency of rapid eye movement (REM) sleep compared with controls (all P