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.

The Free-floating Flexible Dual-arm Space Robot is a highly nonlinear and coupled dynamics system. In this paper, the dynamic model is derived of a Free-floating Flexible Dual-arm Space Robot holding a rigid payload. Furthermore, according to the singular perturbation method, the system is separated into a slow subsystem representing rigid body motion of the robot and a fast subsystem representing the flexible link dynamics. For the slow subsystem, based on the second method of Lyapunov, using simple quantitative bounds on the model uncertainties, a robust tracking controller design is used during the trajectory tracking phase. The optimal control method is designed in the fast subsystem to guarantee the exponential stability. With the combination of the two above, the system can track the expected trajectory accurately, even though with uncertainty in model parameters, and its flexible vibration gets suppressed, too. Finally, some simulation tests have been conducted to verify the effectiveness of the proposed methods.

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 analyze the factors for willingness to pay(WTP)in different quantiles and to provide evidence for formulating premium of minors covered by Urban Residents'Basic Medical Insurance.Methods In a field survey,the study adopted the contingent valuation method and quantile regression to measure and analyze the WTP.Results The influencing factors and degree of influence varied in different quantiles.Annual household income was significant in 10 of 11 quantiles with the maximum marginal effect of 350 yuan.Whether the insured comes from a village in a city affects 8 of the 11 quantiles whereas gender,age and health conditions of minors have minor effect on willingness to pay.Conclusion The premium standard should be raised from 40 yuan per person per year to 100 yuan.Minors can be categorized into subgroups and be set with distinct premiums in terms of the significant influencing factors and its influence degree.

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 study the clinical characteristic and correlation factors of fungal infection in severe acute pancreatitis(SAP). Methods Clinical data of SAP patients with fungal infection (fungus infection group-F1 group) and with bacterial infection (bacteria infection group, B1 group) in January,1994-December,2001 were retrospective analysed and compared. Results There were 40 cases in F1 group, 84 cases in B1 group. There were no significant difference in age, sexual, causes, APACHE II score between the two groups, Hospitalization in F1 was significantly longer than that in B1 group (57.7d∶42.7d, P= 0.044 ).Diabetes-mellitus, SAP grade II, multi-operation, intestinal and/or bile duct fistulas were related to fungal infection in SAP; mortality in F1 group was significantly higher than that in B1 group (P= 0.02 ). Conclusions Diabetes-mellitus, SAP grade II, multi-operation, intestine and/or bile duct fistulas are the risk factors of patients with severe acute pancreatitis developing fungal infection; fungus infection can increase the mortalily of SAP patients.Extra-pancreas fungal infection is commonly seen in digestive tract, respiratory tract and urinary system. unknown consciousness change and massive bleeding may indicate that the patient is complicated with fungal infection.

ObjectiveTo study the early diagnosis and prevention of fungal infection in severe acute pancreatitis(SAP). Method 1.SAP patients from July 1998 to June 2002 were prospectively randomized into 3 groups: garlicin prevention group, fluconazole (low dosage) prevention group and control group, the incidence of fungal infection in SAP was compared between the groups. For fungal infection patients, the fungal clearance and mortality rate were observed. 2.Clinical data of SAP patients with fungal infection and with simple bacterial infection was compared by multivariate logistic regression, and clinical characters and risk factors of fungal infection were evaluated. Results 1.There were lower incidences of fungal infection in garlicin group (16% vs. 30%,P

Objective To determine the prevention and therapy of fungal infection in patients with severe acute pancreatitis (SAP). Methods Seventy patients with SAP admitted from July,1998 to June,2002 were randomly divided into 3 groups: garlicin prevention group, fluconazole (low dosage) prevention group and control group.The incidence of fungal infection, the fungal clearance and mortality after the treatment were compared. Results The incidence of fungal infection in garlicin group and fluconazole group was lower than that in control group. (16%∶30%,P

OBJECTIVETo demonstrate the feasibility of extralevator abdominoperineal excision (ELAPE) for locally advanced low cancer in China.

METHODSA prospective multicenter clinical trial was carried out by 7 general hospitals across China from August 2008 to October 2011. A total of 102 patients underwent ELAPE for primary locally advanced low rectal cancer. There were 60 male and 42 female patients. The patients' characteristics, complications and prognosis were recorded.

RESULTSAll patients underwent the ELAPE procedure successfully. The median operating time was 180 minutes (range 110-495 minutes) and median intraoperative blood loss was 200 ml (range 50-1000 ml). The rates of sexual dysfunction, perineal complications, urinary retention, and chronic perineal pain were 40.5%, 23.5%, 18.6% and 13.7%, respectively. Chronic perineal pain was associated with coccygectomy (12 months postoperatively, t = 8.06, P < 0.01), and the pain might gradually ease over time. Reconstruction of pelvic floor with biologic mesh was associated with lower rate of perineal dehiscence (χ(2) = 13.502, P = 0.006) and overall perineal wound complications (χ(2) = 5.836, P = 0.016) compared with primary closure. A positive circumferential margin (CRM) was demonstrated in 6 (5.9%) patients, and intraoperative perforations occurred in 4 (3.9%) patients. All CRM involvement and intraoperative perforation located at anteriorly and anterolaterally. The local recurrence was 4.9% at a median follow-up of 35 months (range, 18-58 months).

CONCLUSIONSELAPE performed in the prone position for low rectal cancer leads to a reduction in CRM involvement, intraoperative perforations, and local recurrence, but it might result in a little high rate of perineal wound related complications. Reconstruction of pelvic floor with biologic mesh might lower the rate of perineal wound complications.

Adult ; Aged ; Digestive System Surgical Procedures ; methods ; Female ; Humans ; Male ; Middle Aged ; Perineum ; surgery ; Postoperative Complications ; Prognosis ; Prospective Studies ; Rectal Neoplasms ; surgery ; Treatment Outcome