Objective To study the effect of laparoscopic surgery on the quality of life in patients with middle and low rectal cancer.Methods 108 cases with middle and low rectal cancer in accordance with the number table,were randomly divided into two groups.54 patients in the observation group were operated through laparoscopic surgery and 54 patients in the control group received traditional open surgery.The patients were followed up for 6 months,the patients' quality of life were assesed.Results The operative time,blood loss and length of hospital stay in the observation group were less than the control group (P ＜ 0.01).The lymph node dissection between the two groups had no significant difference(P ＞0.05).47 patients in the observation group were rectal sphincter preservation,the rate was 87.0％,37 patients in the control group with rectal sphincter preservation,the rate was 68.5 ％,the difference between the two groups was significant (x2 =4.92,P ＜ 0.05).The patients'quality of life after surgery in two groups was increased than before surgery,and the observation group increased more significantly than the control group(P ＜ 0.05).Conclusion Laparoscopic surgery can significantly improve the quality of life in patients with middle and low rectal cancer.

Compensatory of colateral circulation is a key factor affecting the outcome in patients w ith acute ischemic stroke. This article review s the development of colateral circulation and its affecting factors, and the predictive value of colateral circulation for the outcome in patients w ith acute ischemic stroke.

Objective:Surgery intervention and its effect on pregnancy heart disease were explored. Meth-ods:Retrospective review of 34 cases of pregnancy heart disease who needed surgery intervention from Jan, 2000 to Dec,2007 was done. Results:17 patients had percutaneous balloon mitral valve (PBMV) dilatation, the area of mitral valve enlarged markedly postoperatively ( P <0.01 ). 9 patients had open chest surgery un-der extracorpory circulation,7 of them had re-replacement mechanical valve due to mechanical valve throm-bosis. One patient had left atrium mucomamectomy. One patient had Wad's sinus breakout and repairmen. 5 patients had Radiofrequency catheter ablation (RFCA) for supraventricular tachycardia. 3 patients had int-racardiac device (ICD) for Ⅲ grade atrioventicular block. 22 patients had cardiac function as grade Ⅲ～Ⅳ and postoperatively recovered to grade Ⅰ～Ⅱ . All 34 patients were alive after treatment, 23 fetus were alive (67.6%), and no adverse results were found during the follow-up. Conclusions:When patients who had pregnancy heart disease need surgery intervention, individualized treatment plan should be made by multidis-cipline experienced doctors according to different heart disease and cardiac function.

Objective To study the efficacy and safety of reboxetine and citalopram in treating retardant depression.Methods A total of 59 patients with retardant depression were randomly divided into reboxetine group(n=29)and citalopram group(n=30)for the treatment of 6 weeks.The patients were assessed with the Hamilton depression scale(HAMD)and treatment emergent symptom scale(TESS).Results At the end of 6 weeks,the total scores of HAMD in reboxetine(18.48±6.38)group and citalopram(11.60±4.46)group both significantly decreased(P＜0.001).Between two groups,the efficacy(82.8% and 56.7%)had significant differences(P＜0.05)but side effects had no statistical significance.Conclusion Reboxetine has significant curative efficacy,milder adverse effects and higher safety for treating patients with retardant depression.

Moyamoya disease is a chronic progressive cerebrovascular occlusive disease of unknow n etiology. Transcranial Doppler sonography (TCD) is a non -invasive ultrasonic examination that can detect the hemodynamic characteristics of intracranial large vessels. At present, there are more applications in screen, auxiliary diagnosis, and surgical outcome assessment in moyamoya disease. This article review s the current applications of TCD in moyamoya disease.

Objective To review the neuron synaptic plasticity in hioppocampus in the pathogenesis of depression in present studies,and expected to provide reference and basis for study of depression in clinic and model.Methods The wordsdepression, antidepression, chronic unpredictable stimulate, hippocampus, synapse,plasticity were used as index words.Analysis the relationship of depression or antidepression and synaptic plasticity in hippocampus from the results of researches enrolled at home or abroad.Summarize the effect of neuron synaptic plasticity in hioppocampus in the pathogenesis of depression.Result Totally 37 articles enrolled.They show the onset of depression or antidepressant processes always combine with the damage or recover of neuron synaptic plasticity.Conclusion The reduction or damage in synaptic plasticity in hippocampus is likely to be the pathogenesis of depression,like the changes of function or expression of SYN-1,MAP-2,SYT-1,PSD-95 or any other synapse-associated proteins.Meanwhile,studies of using enrich environment to treat depression indicated that depression is likely related to the synaptic plasticity in hippocampus in another way.But who are the synapse-associated proteins related to synaptic plasticity in depression? How to design the enrich environment.? These still need further study.

Objective Toinvestigatetheclinicalfeaturesandsurgicalprognosisofmoyamoya syndromeinchildren.Methods Theclinicaldataof12childrenwithmoyamoyasyndromeadmittedto the 307th Hospital of People′s Liberation Army from December 2002 to October 2013 were analyzed retrospectively. Eleven of them underwent encephalo-duro-arterio-synangiosis (EDAS). A total of 550 children with moyamoya disease in the same period were used as a control group. The clinical characteristics and surgical efficacy of the children with moyamoya syndrome were summarized and concluded by comparing the clinical data of the two groups,including sex,age of onset,initial symptom,progress symptoms, Suzukiinstallments,imagingfeatures,andsurgicalefficacy.Results Themaleandfemaleratioof the children with moyamoya syndrome was 1∶2. Their mean age of onset was 12 ± 5 years old. There were significant differences in the initial symptom (cerebral infarction and cerebral hemorrhage )and disease progress between the children with moyamoya syndrome group and the control group (5/12 vs. 14. 5%[80/550], 3/12 vs. 61. 8%[340/550],and 5/12 vs. 8.7%[48/550],respectively;all P<0. 05). Within the follow-up period,of the 11 children underwent EDAS,7 cases had no further attack,and 4 cases were improved significantly. There was significant difference in the modified Rankin scale (mRS)between the beforeandaftersurgery(0[0,1]vs.2[1,2];P<0.05).Conclusions Theclinicalfeaturesofthe children with moyamoya syndrome have some differences with those with moyamoya disease. Timely and effective EDAS treatment may effectively prevent disease progression and improve the prognosis of patients.

Objective To develop MFT-2S protective mask with dual canisters and big-eye-window and to improve the three-grade system of protective equipment,so as to solve the problems on protective mask in environment with gas of high concentration.Methods MFT-2S protective mask was derived from MFT-2,with the advantages of MFT-2.The fixation intensity was effectively guaranteed by installing two sets of joint components and stainless steel clamps in the lower part of mask bilaterally.The sealing component was installed in communication component.Each canister was fixed at one side respectively.The fogproof lenses were reinstalled and the length of canister was increased properly.Results The results showed that,compared with MFT-1 mask,the inspiration resistance of MFT-2S mask decreased by a half,its total weight became about 50% of MFT-1 mask,and the leakage coefficient of MFT-2S mask was 0.005 percent.Its antidim character was improved and MFT-2S mask had better protective performance than MFT-2 by twice.Conclusion According to the transformed protection indices,MFT-2S mask,with the advantages of being light,simplified and standardized,can take the place of MFT-1 mask.

Objective To investigated the application value in the efficacy evaluation of transcranial Doppler (TCD) in encephalo-duro-arterio-synangiosis (EDAS) for moyamoya disease. Methods The patients with moyamoya disease treated with EDAS conducted digital subtraction angiography (DSA) and TCD examinations before procedure and at 6 months after procedure respectively. The pulsatility index (PI), resistance index (RI) and mean flow velocity (MFV) before and after the superficial temporal artery surgery were measured respectively. The correlation between the TCD parameter variation rate and DSA efficacy grading was evaluated. Using the receiver operator characteristic (ROC) curve to calculate the optimal cut-off value of the TCD parameters for predicting the operation efficacy. Results A total of 46 patients with moyamoya disease were enroled, 40 patients were bilateral hemisphere involvement and 6 were unilateral involvement. A total of 86 hemispheres were treated with EDAS. According to the results of DSA reexaminations, the grades of efficacy were as folows: grade 0, 18 sides, grade 1, 37 sides, grade 2, 18 sides, and grade 3, 13 sides. When the DSA grade was 0, there were no significant differences in PI, RI and MFV before and after procedure, and there were significant differences in the postoperative change of other TCD parameters at al levels (al P < 0. 001). At 6 months after procedure, the change rates of PI, RI and MFV were - 30. 83% ± 21. 71% , - 19. 64% ± 14. 45% and 96. 08% ± 100. 76% , respectively, and they had good correlation with the results of DSA efficacy grading. Their Spearman correlation coefficients were- 0. 879, - 0. 891 and 0. 715, respectively (al P < 0. 001). ROC curve analysis showed that the best cutoff values of the TCD parameter change rates for predicting good operative effect were as folows: PI decrease rate, 36% (area under the curve, 0. 966; sensitivity, 0. 968, specificity, 0. 891; P < 0. 001), RI decrease rate, 27% (area under the curve, 0. 973; sensitivity, 0. 903, specificity, 0. 946; P < 0. 001), and MFV increase rate, 111% (area under the curve, 0. 879; sensitivity, 0. 742, specificity, 0. 927; P < 0. 001). Conclusions TCD can detect hemodynamic parameter changes of superficial temporal arteries after EDAS. It has higher application value in the long-term postoperative efficacy evaluation.

Background Optic neuritis is one of the common clinical neuro-ophthalmic diseases.Spectraldomain OCT (SD-OCT) is a valuable tool in assessing the thickness changes of retina,while enhanced depth imaging (EDI) OCT can further quantitatively and morphologically evaluate the changes of retina and choroid.The pathological mechanism of optic neuritis is unclear now.Objective This study was to quantitatively measure the retinal and choroidal thickness in early optic neuritis eyes by SD-OCT and EDI OCT.Methods A prospective cohort study was carried out in Tianjin Eye Hospital from July 2015 to May 2016.Twenty eyes of 20 patients with acute optic neuritis were enrolled as optic neuritis group and 22 eyes of 20 healthy subjects with matched age and gender were included in the normal control group.The mean thickness of retinal nerve fiber layer (RNFL) and choriod in superior,inferior,nasal and temporal quadrants at 3.4 mm around optic disc was measured,and the mean thickness of RNFL,ganglion cell layer (GCL),inner plexiform layer (IPL),inner nuclear layer (INL),outer plexiform layer (OPL),outer nuclear layer (ONL) and photoreceptor layer also was measured by EDI OCT.Pattern visual evoked potential (P-VEP) and visual field were examined in all the individuals,the correlations of mean defect (MD) with the thickness of RNFL,choroid and the thickness of RNFL,GCL,IPL,INL,OPL,ONL,photoreceptor layer at macular area were evaluated.Results The RNFL thickness values were (424.00±160.30),(428.40±169.83) and (108.15 ±50.66) μm in superior,inferior,nasal quadrants at 3.4 mm arear around optic disc in the optic neuritis group,which were significantly higher than (265.68±26.25),(283.27±52.81) and (72.68± 12.01) μm in the normal control group (t=4.571,3.814,3.190,all at P＜0.01),and there was no significant difference between the two groups (t =0.849,P =0.401),and no significant differences were found in choroidal thickness of 4 quadrants between the two groups (all at P＞0.05).The thickness of RNFL,GCL and IPL at 1 mm area around macula and the thickness of GCL,IPL,INL at 3 mm area around macula were evidently thining in the optic neuritis group compared with the normal control group (all at P＜0.05).The latency of P100 wave was (133.15±11.11) seconds in the optic neuritis group and that in the control group was (94.59 ±4.38) seconds,showing a significnat difference between them (t =15.058,P＜0.05).Positive correlations were found between MD and the RNFL thickess in superior,inferior,nasal quadrants at 3.4 mm arear around optic disc (r =0.649,0.649,0.635,all at P＜0.05),however,no evidentlylinear correlations were found between MD and choroidal thickness in 4 quadrands (r =-0.120,-0.102,-0.415,0.120,all at P＞0.05),and the thickness of RNFL,GCL,IPL,INL,OPL,ONL,photoreceptor layer at macular area was significantly linear correlated with MD.Conclusions EDI OCT can reflect the RNFL edema around optic disc and thining of various layers of retina at macular area in acuter optic neuritis eyes,however,the choroidal thickess is unchanged.EDI OCT is a useful tool in quantitative evaluation of retinal and choroidal thickness of early optic neuritis.