Objective To observe and evaluate the clinical curative efficacy of perineal stapled prolapse resection in the treatment of complete rectal prolapse.Methods 15 patients of complete rectal prolapse were all treated by perineal stapled prolapse resection,The anal function of the patients were evaluated according to the Wexner incontinence score standard.Results All patients were successfully completed the operation.Postoperative complications:postoperative bleeding in 2 cases,anastomotic stenosis in 2 cases.These symptoms were relieved after symptomatic treatment.The anal sphincter function was improved in all patients after operation.There were no obvious incontinence.The preoperative Wexner incontinence score was 13.5±1.8,andpostoperative Wexner incontinence score was 4.2±1.5,there were significant statistical difference between them(P<0.05).The mean follow-up were 18 months(2-30 months).There was no recurrence during the follow-up period.Conclusion Perineal stapled prolapse resection as a new type of operation had small trauma,simple operation,less complications and short-term curative effect of good characteristics.They can effectively improve the symptoms of anal incontinence in patients with complete rectal prolapse.

Twenty two patients with outlet obstructive constipation (OOC) underwent pelvic fourcontrast defecography preoperatively and postoperatively. Functional outcome and the findings on defecography were analyzed. The inconsistent signs between preoperative and postoperative defecography findings were shown in all patients. Some new abnormal findings, including 5 cases with pelvic floor hernia, 4 with cystocele, 4 with vagina prolapse, 3 with uterine prolapse,2 with rectal prolapsed and 1 with spastic pelvic floor syndrome were present in 5 patients with ineffective surgical treatment and 9 patients with effective surgical treatment. Reduced abnormal signs were showed in the 9 effective patients, but other new abnormalities appeared. The abnormal signs were reduced or disappeared in 8 obviously effective patients and there were no new abnormalities present in those patients. Results indicate that pelvic four-contrast defecography can provide valuable information for patients with OOC postoperatively.

Objective To explore the changes of urinary Trypsinogen Activation Peptide (TAP) levels in patients with acute pancreatitis (AP).Methods We observed the association between urinary TAP concentration and severity of acute pancreatitis with competitive enzyme-linked immunosorbent assay(ELISA). Urine samples were collected for TAP concentration at admission,24,48,and 72 h from 57 patients with AP who presented within 48 h of the onset of symptoms and from 11 control patients. Results The median urinary TAP at admission for severe acute pancreatitis(SAP) (98 nmol/L) was signficantly higher than the median for both mild pancreatitis (22 nmol/L,P0.05).The peak median urinary TAP in severe eroup was seen at admission.In the following days,TAP concentrations decreased graduallg.Conclusion Breakthrough activation of trypsinogen in pancreatic interstitial and blood may be the key event in the development of SAP.

Objective To investigate the value of TAP in the early prediction of severe acute pancreatitis (SAP) and to compare it with acute physiology and chronic health evalutionⅡ (APACHEⅡ).Methods We observed the association between TAP concentration and the severity of acute pancreatitis with competitive enzyme-linked immunosorbent assay(ELISA). Urine samples were collected for the measurement of TAP concentration at admission, 24,48,and 72*!h after from 41 patients with acute pancreatitis (AP) (12 severe cases, and 29 mild) who presented within 48*!h of the onset of symptoms and from 11 control patients, while APACHEⅡ scores were recorded at 48*!h after admission. Results The TAP at admission of SAP (95*!nmol/L) was signficantly higher than that of mild (20*!nmol/L; P

Objective To study the inhibitory effects of hydroxyapatite nanoparticles on liver VX2 tumor in rabbits after intratumoral injection. Methods 40 rabbits with implantation of liver VX2 tumors were randomly divided into 4 groups and intratumorally injected with different preparations.Group A: (control group), 1 ml nomal saline containing 0.2% CMC-Na; Group B: ( 5-Fu group),20 mg/ml 5-Fu 1 ml; Group C: (Nano HAP), 20 mg/ml Nano HAP 1 ml; Group D: (5-Fu+Nano HAP), 20 mg/ml 5-Fu 1 ml and 20 mg/ml Nano HAP 1 ml. Ultrasonography was performed to measure liver tumor volume 7, 14, 21 d after treatment. Survival durations of the animals were recorded. Tumor tissues and liver tissues close to tumor were obtained and examined histologically.Results The average tumor volumes 7, 14 and 21 d after treatment were (4.93 ±0.76)cm3,(15. 67±2.75)cm3 and (52. 36±10. 57)cm3 in group A, (4. 16±0. 33)cm3 , (10. 26± 1.60)cm3 and (18. 89±4.65)cm3 in group B, (1.43±0.13)cm3 , (3.69±0.77)cm3 and (9.51±2.09)cm3 in group C, (2. 80±0.46)cm3 , (3. 77±0. 91)cm3 and (8. 46±0.95)cm3 in group D respectively. The average tumor volumes of groups B, C and D were significantly smaller than that of group A in the same time phases after treatment. The life span of group C was longer than that of other three groups, and there was no statistically significant difference between group B and group D, although the two groups were significantly longer than group A. Blood flow was not detected by color Doppler or power Doppler in group C and group D. Pathological examination showed that there was obvious intratumoral necrosis in group C and D. Tumor in group B exhibited thoroughgoing necrosis. Conclusion Hydroxyapatite nanoparticles intratumoral injection is safe and feasible for treatment of liver tumor. Hydroxyapatite nanoparticles can exert a significant inhibitory effect on liver VX2 tumor growth in rabbits without liver toxicity.

Objective To investigate the relationship between hypoxia inducible factor-1?、angiopoietin2 and vascular endothelial growth factor and angiogenesis in hepatocellular carcinoma(HCC).Methods The(expression) of hypoxia inducible factor-1?、angiopoietin2 and vascular endothelial growth factor mRNA was(detected) in 52 HCC surgical specimens.And microvessel density(MVD) in tissue specimens of patients with coexpression of the parameters was examined.Results Of the 52 surgical specimens,36 cases had over(expression) of HIF-?、angiopoietin and VEGF protein,and coexpression of HIF-? and angiopoietin and VEGF mRNA in 38 of 52 cases.The expression of HIF-?、angiopoietin was related with the expression of VEGF(r_1= 0.783,P

AIM: To observe the expression of HIF-1? mRNA, HIF-1?, VEGF and iNOS proteins and to investigate their relationship in h ypoxia-treated SW480 cells. METHODS: HIF-1?, VEGF and iNOS proteins were measured by immuno cytochemistry. Western-blot was used to detect HIF-1? protein. HIF-1? mRNA wa s measured by in situ hybridization. RESULTS: Under hypoxic condition, SW480 cells expressed proteins of HIF-1?, VEGF and iNOS more strongly than that under normoxia condition. How e ver, under hypoxia condition, these three proteins expressed weakly or negativel y when the cells treated with genistein, the inhibitor of HIF-1?. Expressions o f HIF-1? and VEGF proteins in cultured SW480 cells under hypoxic condition were completely or partially inhibited by the addition of SNP but the expression of iNOS was unaffected. Another NO donor NOC5, however, induced the expression of t hese three proteins. L-NAME, a non-specific inhibitor of NOS, inhibited the expr ession of HIF-1?, VEGF and iNOS. The levels of HIF-1? mRNA changed slightly i n different oxygen condition or addition of genistein, NO donor or iNOS inhibitor . CONCLUSIONS: Hypoxia induces the expression of HIF-1?, therefor e upregulates the production of VEGF and iNOS. During hypoxia, SNP inhibits but N OC5 promotes HIF-1? expression, indicating that different NO donor acts on the cells through different mechanisms.

Objective To observe the Lactulose Oral Solution's influence in PPH postoperative complications and patients′ satisfactory rate for constipation and to find more intervention measures for reducing the complications. Methods A hundred and twenty cases of hemorrhoids with constipation were randomly divided into the two groups: the experimental group, the control group in 60 cases in each group. All patients’ postoperative bleeding, anal edema, stool impaction and satisfaction were observed and compared within 30 days. Results In the control group, the postoperative bleeding’ cases were of 23, anal edema’s were of 20 and stool impaction‘s were of 8. The incidence was 38.3%, 33.3% and 13.3% severally. The satisfactory patients were of 49 and the degree of satisfaction was of 81.7%. In the experimental group, the postoperative bleeding’ cases were of 12, anal edema’s were of 8 and stool impaction's was of 1. The incidence was 20%, 13.3% and 1.7% respectively. The cases who were satisfactory were of 58 and the degree of satisfaction was 96.7%. The postoperative bleeding , anal edema , stool impaction and satisfaction were different statistically in the two groups above (P < 0.05). Conclusion It can reduce PPH postoperative complications and increase patients′satisfaction by using Lactulose Oral Solution in patients with constipation and it will have a certain clinical value if these patients take this oral solution routinely.

Objective To investigate the diagnosis and treatment of malignant fibrous histiocytoma (MFH) in abdominal cavity. Methods The clinical manifestations, imaging examination, pathology, methodology, effect of treatment and prognosis of 28 MFH patients were retrospectively analyzed. Results Tumors were in the retroperitoneal space in 17 cases, within abdominal cavity in 6, in mesentery in 3 cases, and in the abdominal wall in 2 cases. The clinical symptoms were body weight loss, abdominal pain and mass. B ultrasonography and CT scanning showed mass in the abdomen. 24 cases were with multiplefoci,4 cases were with a single mass. Seventeen cases underwent complete tumor resection,11 cases with partial resection, 16 cases received postoperative chemotherapy and 14 cases with postoperative radiotherapy. The overall survival rate of 1-, 3- and 5- year was 76.9%,26.9% and 3.9%,respectively. Conclusion MFH is most often located in retroperitoneal space, surgical resection was the treatment of choice. The prognosis in patients with MFH might be improved by complete resection combined with chemotherapy or/ and radiotherapy.

Objective To observe the clinical effect of thrombus removal of external hemorrhoid combined with procedure for prolapse and hemorrhoids(PPH) in the treatment of circumferential mixed hemorrhoid with incarceration.Methods A total of 118 cases of circumferential mixed hemorrhoid with incarceration were divided into two groups:experimental group of 60 cases was treated by thrombus removal combined with PPH;control group of 58 cases was treated by Milligan-Morgan.We observed the differences of postoperative visual analogue scale (VAS)score,edema,bleeding,residual skin tag,wound healing time,anal stenosis,fecal incontinence,anorectal manometry and satisfaction in the two groups.Results There was significant difference between the experimental group and the control group in postoperative edema,bleeding and residual skin tag(χ2=6.63,4.19,6.64,P<0.05),but postoperative anal stenosis and fecal incontinence weren′t statistically significant different(χ2=0.38,1.11,P>0.05).Postoperative VAS score,wound healing time,satisfaction,anal resting and anal maximal squeeze pressure between the two groups were all statistically different(P<0.01).Conclusion The operation of thrombus removal of external hemorrhoid combined with PPH can effectively reduce the postoperative complications and promote recovery.