Denonvilliers fascia locating between the front of the rectum and urogenital organs is an important barrier separating the urogenital organs and the rectum.It has great significance in the clinical treatment of rectal tumors and genitourinary system tumors.However,controversial on the embryological origins and anatomic characteristics of the Denonvilliers fascias still exist.In this article,the embryonic origin,anatomical structure,adjacent structures and clinical applications of the Denonvilliers fascias were introduced.

Objective:To observe influence of qingzhifugan pellet on mixed-type animal model of fatty liver with chronic hyperlipemia and alcoholized hepatic damage. Methods:The mixed-type animal model of fatty liver was established by administering with high lipids and alcohol feeds. Therapeutic experiments were conducted with a self-made new drug the qingzhifugan pellet. The efficacy of the tested drug was evaluated comprehensively by such measures as sero-level of lipids and ferments,as well as the histological pathology of liver. Results:It was shown that the tested drug can decrease the sero-level of lipids,promote the metabolism of lipids in liver,recover the alcoholized hepatic damage,and relieve the liver fat denaturation. Conclusion:It suggested that the tested drug possessed certain effect for treating or improving chronic hyperlipemia and alcoholized hepatic damage in the animal model.

Objective To evaluate the safety and feasibility of cruciform anastomosis in the laparoscopic radical resection of colon cancer.Methods The retrospective descriptive study was adopted.The clinicopathologic data of 9 patients with colon cancer who were admitted to the Shanxi Provincial Caner Hospital between December 2011 to October 2013 were collected.After the laparoscopic free colon and dissection of lymph nodes,the proximal and distal ends of the colon tumor were cut off using an ENDO-GIA,cutting one small incision on the both side of stump,and ENDO-GIA was put into the incision to staple the mesentery of colonic wall,finally,the beak-like common incision was closed by ENDO-GIA and digestive tract construction was conducted.Observation indices:(1)operative indices:operation time,time of cruciform colon anastomosis,volume of intraoperative blood loss,conversion to open surgery.(2)Tumor indices:number of lymph nodes dissected,distance to resection margin,R resection.(3)Surgical complications:anastomotic stoma incompetence,anastomotic leakage,anastomotic stenosis,twisting of bowel,wound liquefaction infection.(4)Postoperative recovery time:time for initial out-of-bed activity,time to anal exsufflation,time for fluid diet intake,duration of postoperative hospital stay.(5)Follow-up situations:follow-up using outpatient examination was conducted up to April 2014.Karnofsky performance status(KPS)score was used to evaluate the health conditions and tumor recurrence of anastomotic stoma and colonic cavity stenosis were detected by fibercoloscope.Measurement data with normal distribution were presented as x±s.Results(1)Operative indices:9 patients received successful total laparoscopic resection of colon cancer+D3 lymph node dissection+cruciform anastomosis,without conversion to open surgery.Operation time,time of cruciform colon anastomosis and volume of intraoperative blood loss were respectively(140±50)minutes,(43±26)minutes and(62±56)mL.(2)Tumor indices:the number of lymph nodes dissected was 17±6 percase.The distance to resection margin was more than 8 cm,and pathological findings showed no residual cancer.(3)Surgical complications:9 patients had no postoperative complications.(4)Postoperative recovery time:time for initial out-of-bed activity,time to anal exsufflation,time for fluid diet intake and duration of hospital stay were respectively(1.8±0.9)days,(2.4±1.2)days,(3.6±1.7)days and(9.6±2.5)days.All the patients were discharged from hospital at postoperative day 12,without the occurrence of readmission within postoperative day 30.(5)Follow-up situations:all the patients were followed up by outpatient examination at postoperative month 6,with KPS score≥90 and without the occurrence of tumor recurrence of anastomotic stoma and colonic cavity stenosis.Conclusion Cruciform anastomosis in the laparoscopic radical resection of colon cancer is safe and feasible.

Rectal cancer has become the second most common gastrointestinal tumor in our country. With the development of comprehensive treatment, the long-term survival rate of patients with rectal cancer has greatly increased, meanwhile, higher postoperative quality of life is required. But the genitourinary dysfunction which is mainly caused by intraoperative pelvic autonomic nerve damage haunts postoperative rectal cancer patients. Traditional pelvic autonomic nerve protection technology born in the 1980s only improves urogenital function in a part of postoperative patients. In recent years, NOME(nerve-oriented mesorectal excision) was proposed, which needed to make pelvic autonomic never exposed. However, recovery of urinary function is not ideal due to difficulty identifying pelvic autonomic nerve and unavoidable damage on pelvic autonomic nerve. In clinical practice, we found that pelvic autonomic nerve can be divided into three parts: abdominal cavity, large pelvis, small pelvis. The pelvic autonomic nerve is closely related to the surrounding fascias in each part. The fascias are not only the protection of pelvic autonomic nerve, but also can be used as a good indicator of location of pelvic autonomic nerve. The relationship of pelvic autonomic nerve with Toldt fascia, presacral fascia, the lateral rectal ligaments, and the Denonvilliers fascia is discussed in this paper. Combined with the above theory, a new technology named FOPANP (fascia-orientation of pelvic autonomic nerve preservation) is proposed. In this technique, the fascia around the rectum is used as a guidance to select the appropriate plane in the operation, and the tumor can be removed without exposing the pelvic autonomic nerve. This technology has three advantages. First, it is not necessary to search and expose the pelvic autonomic nerve, so as to avoid secondary injury to it during the operation. Secondly, the pelvic fascias are natural barriers formed between the surgical plane and the pelvic autonomic nerve retained. They can avoid the stimulation of physical and chemical factors to pelvic autonomic nerve. Thirdly, because the fascias are easier to identify, and the texture is more tough, so the technology is easier to master.

OBJECTIVETo elucidate the course of pelvic autonomic nerves and its relationship with pelvic fascia in order to identify the safe plane to reduce the damage of pelvic autonomic nerves in total mesorectum I excision(TME).

METHODSThe course and distribution of pelvic autonomic nerves were observed and their relationship with pelvic interfascial space was examined through the anatomy of 12 adult pelvic specimens.

RESULTSThe entire course of hypogastric nerves ran within the anterior sacral fascia and the inferior hypogastric plexus ran within parietal fascia. Inferior hypogastric plexus crossed the fusion line of Denonvilliers fascia and parietal fascia in the 10 o'clock and 2 o'clock directions of the rectum, and joined urogenital vessel bundle finally. Laterigrade traffic nerves could be found in Denonvilliers fascia.

CONCLUSIONThe safe plane should be chosen between rectal proper fascia and anterior sacral fascia near rectal proper fascia in posterior dissection and lateral dissection of rectum. More attention should be paid to protect the neurovascular bundle in the 10 o'clock and 2 o'clock directions of rectum and traffic nerve within Denonvilliers fascia in anterior dissection.

Autonomic Pathways ; anatomy & histology ; surgery ; Female ; Humans ; Male ; Pelvis ; innervation ; Rectum ; surgery

OBJECTIVE: To determine the effect of Tongxinluo on the endothelial function and hypersensitive C-reactive protein (hs-CRP) in acute coronary syndrome patients undergoing percutaneous coronary intervention(PCI). METHODS: Thirty-three patients with unstable angina pectoris and 6 patients with acute myocardial infarction who underwent PCI for stenotic lesions of the coronary artery were enrolled. The patients were randomly assigned to a conventional group (n = 19) which took routine treatment or a tongxinluo group (n = 20) which took Tongxinluo(4 capsules once, 3 times per day) at the base of routine treatment after PCI. Nitric oxide synthase (NOS), nitric oxide (NO), endothelium-dependent vasodilation which was evaluated in the brachial artery flow mediated diameter(FMD) and hs-CRP were measured before the PCI and 24 hours and 3 months after the PCI. The correlation between NO and hs-CRP was analyzed. RESULTS: NOS, NO, and FMD in the 2 groups 24 hours after the PCI were significantly lower than those before the PCI(P < 0.05), but hs- CRP obviously increased (P < 0.05). NOS, NO, and FMD 3 months after the PCI in the 2 groups were significantly higher than those before the PCI (P < 0.05 or P < 0.01), but hs-CRP obviously decreased (P < 0.01).All indexes mentioned above in the Tongxinluo group showed greater changes than those of the conventional group(P < 0.05). NO was negatively correlated with hs-CRP (r = -0.3219, P<0.01). CONCLUSION Tongxinluo capsules have obvious beneficial effect on endothelial function and anti-inflammation in acute coronary syndrome patients undergoing PCI, by directly acting on the endothelium and indirectly inhibiting inflammation.
Acute Coronary Syndrome ; blood ; physiopathology ; therapy ; Aged ; Angioplasty, Balloon, Coronary ; methods ; C-Reactive Protein ; metabolism ; Drugs, Chinese Herbal ; therapeutic use ; Endothelium, Vascular ; drug effects ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy

Objective:To analysis the characteristics and trends of non-martial and non-commercial heterosexual transmission of HIV/AIDS cases in Henan province between 2015 and 2020.Methods:Information of newly reported HIV/AIDS through non-martial and non-commercial heterosexual transmission was collected from National Comprehensive HIV/AIDS Information system, using SPSS 22.0 to analyze the characteristics and tend of cases.Results:During 2015-2020, a total of 10 877 HIV/AIDS cases infected by non-martial and non-commercial heterosexual transmission were newly reported in Henan province. This mode of infection increased from 32.6% in 2015 to 35.5% in 2020 (trend χ2=81.880, P<0.01). The male to female ratio was 1.9∶1 (7 105∶3 772). The mean age was (45.5±15.8) years, increasing annually ( F=5.184, P<0.01). For female cases, the proportion of aged 15-50 years group was decreased annually (trend χ2=69.888, P<0.01). Most HIV/AIDS cases were distributed in the early HIV epidemic areas and Zhengzhou city, the same as the cases of the first CD4 +T cells counts (CD4) below 200 cells/μl. The median ( P 25, P 75) first CD4 count was 298 (143, 462) cells/μl. The proportion of the first CD4<200 cells/μl was no significant change annually, while the proportion of the first CD4≥500 cells/μl was decreasing annually (trend χ2=18.961, P<0.01). Conclusions:The reported cases through non-martial and non-commercial heterosexual transmission increased, with most of them were male, married, junior, farmer, migrant laborer, and aged 40-59 years. It is needed to focus on the rural district and the middle-aged population, combined with biological and social factors to control the prevalence of AIDS through comprehensive prevention and control measures.

Objective To elucidate the course of pelvic autonomic nerves and its relationship with pelvic fascia in order to identify the safe plane to reduce the damage of pelvic autonomic nerves in total mesorectaI excision(TME). Methods The course and distribution of pelvic autonomic nerves were observed and their relationship with pelvic interfascial space was examined through the anatomy of 12 adult pelvic specimens. Results The entire course of hypogastric nerves ran within the anterior sacral fascia and the inferior hypogastric plexus ran within parietal fascia. Inferior hypogastric plexus crossed the fusion line of Denonvilliers fascia and parietal fascia in the 10 o′clock and 2 o′clock directions of the rectum, and joined urogenital vessel bundle finally. Laterigrade traffic nerves could be found in Denonvilliers fascia. Conclusion The safe plane should be chosen between rectal proper fascia and anterior sacral fascia near rectal proper fascia in posterior dissection and lateral dissection of rectum. More attention should be paid to protect the nervovascular bundle in the 10 o′clock and 2 o′clock directions of rectum and traffic nerve within Denonvilliers fascia in anterior dissection.

Objective To elucidate the course of pelvic autonomic nerves and its relationship with pelvic fascia in order to identify the safe plane to reduce the damage of pelvic autonomic nerves in total mesorectaI excision(TME). Methods The course and distribution of pelvic autonomic nerves were observed and their relationship with pelvic interfascial space was examined through the anatomy of 12 adult pelvic specimens. Results The entire course of hypogastric nerves ran within the anterior sacral fascia and the inferior hypogastric plexus ran within parietal fascia. Inferior hypogastric plexus crossed the fusion line of Denonvilliers fascia and parietal fascia in the 10 o′clock and 2 o′clock directions of the rectum, and joined urogenital vessel bundle finally. Laterigrade traffic nerves could be found in Denonvilliers fascia. Conclusion The safe plane should be chosen between rectal proper fascia and anterior sacral fascia near rectal proper fascia in posterior dissection and lateral dissection of rectum. More attention should be paid to protect the nervovascular bundle in the 10 o′clock and 2 o′clock directions of rectum and traffic nerve within Denonvilliers fascia in anterior dissection.

Ubiquitination is one of the most important post-translational modification processes in eukaryotic cells,in which the ubiquitin molecules and/or ubiquitin chains are covalently transferred to the substrate after a series of enzymatic cascade reactions involving the activating (E1),conjugating (E2) and ligating (E3) enzymes.Coupling to the 26S proteasome complex to form the Ubiquitin-Proteasome System (UPS),ubiquitination plays an essential role in controlling protein stability,thereby maintaining the dynamic balance of the key cellular proteins.Besides,ubiquitination is also involved in a wide range of protein degradation-independent events,such as gene transcription and translation,signal transduction,DNA repair and endocytoais,exerting a key function in response to exogenous stimuli and the cellular homeostasis.Similar to kinases,components of the ubiquitination system are often dysregulated,leading to a variety of diseases,such as cancer.Recently,accumulating evidence has shown an increasing number of dysregulated ubiquitination processes in osteosarcoma (OS).Herein,this review briefly provides current perspectives on the aberrance of ubiquitination-associated factors and their roles in OS,providing novel insight into potential therapeutic targets of OS.