Transanal total mesorectal excision (taTME) is a hot topic surgical approach in the field of colorectal surgery. However, the therapeutic effect of this surgical approach is controversial. Based on the accumulated experience and evidence, the domestic and international consensus and guidelines on taTME have been updated and improved. The importance of taTME registry study is emphasized again in the 'International expert consensus guidance on indications, implementation and quality measures for transanal total mesorectal excision' published in 2020. The implementation of prospective case registration is the fundamental premise to ensure the quality of data and the advancing data collection methods and online platform construction can further improve the quality of data. Based on the latest taTME international consensus, the authors discuss the importance of case registry study to improve the data quality of taTME registry study and provide reliable and timeliness evidence based medicine in the field of colorectal surgery.

Objective The study aimed to compare the vector system with the hand instrument in the pain severity during scaling and root planning.Methods 60 periodontal patients were randomly divided into two groups for supportive periodontal therapy (SPT):the experimental group (using vector system) and the control group (using gracey instruments),with 30 cases in each group.And the painfulness after SPT was evaluated by Visual Analogue Scale (VAS).Results 66％ patients felt mild pain during the supportive periodontal therapy with the application of vector system,while 36％ patients felt mild pain in the control group.24 patients in the experimental group accepted vector system for SPT and 23 patients in the experimental group felt less fear of the treatment.Conclusions Patients will feel less discomfort with the application of the vector system,therefore better compliance will be reached.And the cooperation of the doctors and nurses has great impact on the treatment effect.

Objective In this article we evaluated the sensitivities and specificities of real-time PCR assay for diagnosis of human brucellosis.Methods The species selectivity and specificity of real-time PCR were evaluated by direct amplification of a 169 bp portion of bcsp31 gene from 15 Brucella strains and 41 non-Brucella strains.According to the monitoring results of 2012 Harbin brucellosis,17 brucellosis patients and 30 health people were selected to collect their serum samples for assessing the sensitivity of real-time PCR,and additional 30 nonbrucellosis patients serum samples were as controls.Results The species selectivity and specificity of our realtime PCR method were evaluated by using genomic DNA from 15 Brucella strains and 41 non-Brucella strains.There were 11 sera with positive amplification signals among the 17 culture-proven brucellosis patients,the sensitivity was 64.7％(11/17).Whereas,the results of sera from the 60 control patients were all negative,corresponding to a specificity of 100.0％.Conclusion The results indicate that real-time PCR is well suitable for confirmation of brucellosis cases.

BACKGROUND: It is difficult to culture human dental pulp cells in vitro. Studies regarding effects of growth factors on proliferation and differentiation of dental pulp cells cultured in vitro have been reported. However, little is known about the Chinese herb rhizoma drynariae decoction on dental pulp cells cultured in vitro.OBJECTIVE: To observe the effects of different concentrations of rhizoma drynariae decoction on the proliferation and differentiation of human dental pulp cells cultured in vitro.DESIGN, TIME AND SETTING: A controlled observation was performed at the Scientific Resaarch Center, Fourth Hospital, Hebei Medical University between March 2006 and May 2007.MATERIALS: Human dental pulp cells were sourced from the patients who acquired orthotherapy through pulling out impacted wisdom tooth at the Department of Stomatology, Fourth Hospital, Hebei Medical University. Written informed content of sample collection was obtained from all patients. Rhizoma drynariae (place of production: Yunnan Province in China) was provided by the Dispensary of Traditional Chinese Medicine, Fourth Hospital, Hebei Medical University.METHODS: Human dental pulp cells were cultured in vitro using method of tissue piece. The effective ingredients of rhizoma drynariae were extracted by alcohol deposition. 1 mL of physic liquor contained 1 g crude drug and diluted into 10, 50, 100, 500, and 1000 mg/L culture medium utilizing fetal bovine serum. Subsequently, the prepared culture medium was used to culture human dental pulp cells in vitro. Cells that were cultured using culture medium without rhizoma drynariae decoction were used as controls.MAIN OUTCOME MEASURES: ①Primary culture and source identification of human dental pulp cells. ②Effects of different concentrations of rhizoma drynariae decoction on proliferation of human dental pulp cells by methyl thiazolyl tetrazolium (MTT) assay. ③ Effects of different concentrations of rhizoma drynariae decoction on fibronectin expression in human dental pulp cells by immunohistochemistry. ④ Effects of rhizoma drynariae decoction on ultrastructure of human dental pulp cells utilizing scanning electron microscope and transmission electron microscope.RESULTS: Primarily cultured human dental pulp cells displayed polygon- and shuttle-shaped appearance. Different concentrations of rhizoma drynariae decoctions, in particular 100 mg/L, exhibited proliferation-promoting effects on proliferation of human dental pulp cells, and could induce dental pulp cell synthesis and secrete fibronectin. Electron microscopy results revealed that following treatment of rhizoma drynariae decoctions, human dental pulp cells were found with abundant ridges on their surface, surround by extracellular matrix, cytoplasm full of abundant rough endoplasmic reticulum and dissociative ribosome, as well as evenly dispersed nuclear euchromatin, and occasionally seen heterochromatin.CONCLUSION: 100 mg/L rhizoma drynadae decoction apparently promotes the proliferation of human dental pulp cells cultured in vitro.

BACKGROUND:Keloid is the outcome of wound-healing process,and the result of massive accumulation of life-prolonged fibroblasts with gene mutation as well as the excessive synthesis of collagenous fibers.OBJECTIVE:To probe into the structural relations of exons 7-9 of fibroblastic Fas gene in keloid tissues.DESIGN:A self-controlled experimental study with cicatricial tissues as the subjects.SETTING:Department of Plastic Surgery of Southern Hospital of the First Military Medical University of Chinese PLA.PARTICIPANTS:This experiment was carried out at the Tropical Disease Research Institute of the First Military Medical University of Chinese PLA in 2001. All keloid and hypertrophic scar tissues were obtained from the patients who received orthopedic surgical operations at the Southern Hospital, including 15 patients with keloid and 12 patients with hypertrophic Scars. Normal skin and peripheral blood were obtained from the keloid patients as self-control. Meanwhile pathological tissues and normal skin and peripheral blood were obtained from patients with hypertrophic scars as normal control.INTERVENTION:PCR-single strand conformation polymorphism was used to find the structure of the exons 7-9 in Fas gene in15 patients with keloid.MAIN OUTCOME MEASURES:The structure of the exons 7-9 in Fas gene.RESULTS:Heterozygous loss of Fas gene exon-8 was observed in all the 15 keloid patients, and 20% of them displayed an increase in exon-9 allele band.CONCLUSION: The genetic structure of Fas gene showed no mutation in hypertrophic scars, normal skin and the peripheral blood,but mutations were detected in exons-8 ,and -9 of Fas gene in keloid. This was closely related with the disfunction of its encoded proteins.

Objective:To evaluate the effect of occlusal adjustment on the restoration of the idiopathic cervical lesions.Methods:295 teeth with dental idiopathic cervical lesions in 83 patients were divided into 2 groups,142 teeth with occlusal interference were included in group 1 and the 153 without occlusal interference in group 2.The deffects of all the teeth were filled with Z350 nano-resin and followed up for 2 years.Then the teeth with treatment failure were divided into the experimental group (A,30 from group 1 and 14 from group 2) and the control group(B,30 from group 1 and 15 from group 2).The idiopathic cervical lesions of all teeth were filled with Z350 nano-resin,the occlusion of the corresponding teeth in group A was adjusted at the same time,that of group B was not treated.The cases were followed up for 1 year.Results:The success rate of group 1 and group 2 was 57.75％ and 81.05％ repectively (P ＜ 0.05).A subsequently treatment and 1 year follow-up showed that the success rate of gorup A and B for the cases with treatment failure of group 1 was 83.33％ and 56.67％ (P ＜ 0.05),for group 2 was 85.72％ and 40％ (P ＜ 0.05) respectively.Conclusion:The occlusal adjustment is benefit to the clinical effect of the treatment outcome of idiopathic cervical lesions.

BACKGROUND:Keloid is the outcome of wound-healing process,and the result of massive accumulation of life-prolonged fibroblasts with gene mutation as well as the excessive synthesis of collagenous fibers.OBJECTIVE:To probe the relationship between the fibroblasts and the mutations of the exon-8 of Fas gene in keloid.DESIGN:An open study with gene sequence as the subjects of observation.SETTING :The Department of Plastic Surgery of Southern Hospital of the First Military Medical University.PARTICIPANTS:This experiment was carried out at the Tropical Disease Research Institute of the First Military Medical University of Chinese PLA in 2001. All keloid and hypertrophic scar tissues were obtained from the patients who received orthopedic surgical operations at the Southern Hospital, including 15 patients with keloid whose pathological areas were located respectively at the earlobe and the prothorax and 12patients with hypertrophic scars whose pathological areas being located at the instep and the elbow. At the same time, normal skin and the peripheral blood samples from the patients themselves with keloid were taken as the self-control and the skin and the peripheral blood samples from the normal people and the patients with hypertrophic scars were taken as the normal control.METHODS: PCR-SCCM technique and gene sequence analysis were used to detect the gene structure of exon-8 in the Fas gene from 15 patients.MAIN OUTCOME MEASURES:The gene structure of exon-8 in the Fas gene derived from the tissues and the peripheral blood samples of all the groups.RESULTS: ① Heterozygous loss was observed in the exon-8 of the Fas gene in all 15 keloid patients; ② Gene sequence was found to be abnormal in 11 cases out of 15 keloid patients, presenting gene mutation in 4 loci.CONCLUSION: Heterozygous loss and gene mutation was detected in the exon 8 of Fas gene of keloid, suggesting that Fas protein in keloid has functional defect that is closely associated with gene mutation.

Intracorporeal anastomosis in laparoscopic right hemicolectomy of colon cancer is becoming a hot spot in colorectal surgery. A number of retrospective studies have suggested that intracorporeal anastomosis has potential advantages in promoting postoperative recovery and reducing postoperative complications compared with conventional extracorporeal anastomosis. Several randomized controlled trials published recently have also confirmed that intracorporeal anastomosis can promote postoperative gastrointestinal function recovery and reduce postoperative pain, but there is still insufficient evidence to draw a conclusion about the incidence of complications, especially the anastomotic leakage rate. Heterogeneity of surgical techniques and unclear definition of anastomotic leakage are the main difficulties in current studies. Several high-quality prospective randomized controlled trials are currently under way, and high level of evidence is needed to objectively evaluate the laparoscopic right hemicolectomy of colon cancer. The authors review the relevant literatures at home and abroad, systematically elaborate the research status and prospects of digestive tract reconstruction after laparoscopic right hemicolectomy of colon cancer, in order to explore a new direction for the clinical research of colorectal surgery in China.

Objective To evaluate the value of spiral CT and panoramic radiographs in preoperative assessment the jaw condition of patients for dental implantation.Methods 80 patients required dental implant restoration,these patients were Manned by CT and panoramic radiographs in preoperative,then selected suitable patients for dental implant restoration,reconstructed the jaw based on spiral CT data and guided the dental implant design and implanration.Results The spiral CT examination could be more accurate selection criteria for the patients needed dental implant restoration and more accurately showed the situation of edentulous ridge bone.Conclusion The reconstructed of three-dimensional imaging of spiral CT could precisely show the bone situation in the jaw needed dental implant and the important anatomic structures,could effectively assist denture design and the direction and depth of dental implants.was more superiority than panoramic radiographs.

Objective To make a summary of the clinical application and cooperation of piezosurgery in jaw bone tumour operation. Methods 64 patients with jaw bone tumour were selected since 2007 and were divided into the piezosurgery group and the routine group, they used piezosurgery and routine osteotome respectively. Feelings during operation, operation time, hemorrhage, postoperative reaction and complication were observed and compared. Results Discomfort and hemorrhage during operation was lighter, but operation was longer in the piezosurgery group compared with the routine group. Complications such as postoperative infection, hemorrhage and nerve damage did not occurred. Conclusions Application of piezosurgery in jaw bone tumor operation can increase comfort degree and reduce hemorrhage, it requires proficiency in operation procedures and master key aspects of nursing, so that can cooperate well.