Objective To investigate the therapeutic effect of laparoscopic radical resection of rectal carcinoma via natural orificespecimen extraction(NOSE). Methods Laparoscopic resection of rec-tal carcinoma was performed using NOSE technique in 35 cases of rectal cancer from October 2013 to 2015 July. Analysis of clinical data,postoperative exhaust time,the number of resected lymph node,and anastomotic leakage rate was conducted. Results All 35 cases underwent laparoscopic radical resection of rectal cancer with successful anus preservation. There were no preventive transverse colostomy. Among them,the success rate of laparoscopic radical resection via NOSE for rectal cancer was 85. 71%(30 /35). The operation duration ranged from 105 to 186 min(mean 129. 50 min). Anal exhaust time was 22 to 80 h(average 38. 13 h). Postoperative hospital stay lasted for 9 ~ 21 days(mean 10. 27 d). Anas-tomotic leakage occurred in 1 case and puncture infection in 2 cases. Conclusion Laparoscopic radical resec-tion of rectal carcinoma in middle and low rectal cancer is safe and reliable,which is worthy of being spread.

Objective To evaluate the clinical efficacy of transcatheter renal sympathetic denervation(RDN)in the treatment of resistant hypertension.Methods Clinical data of 10 patients with resistant hypertension treated by transcatheter renal sympa-thetic denervation were retrospectively analyzed.The blood pressure and complications were analyzed.Results In all of the 10 pa-tients,systolic and diastolic blood pressure decreased significantly after two weeks compared with preoperative,and further de-creased after 3 months (P <0.05 ).There were no statistical difference of systolic and diastolic blood pressure between 3 and 6 months(P >0.05).Before the RDN,the mean number of antihypertensive drugs was 5.3±0.9.After 6 months which was 3.2±0. 6,and which was decreased significantly compared with the preoperative (P <0.05).No adverse reactions were found.Conclusion The RDN can be quickly and sustained decrease the blood pressure in patients with resistant hypertension.

Objective To construct the eukaryotic expression vector harboring the fragment of Alia gene, and to investigate the effects of it on the signal of quorum sensing and virulence factors producted by Pseudomonas aeruginosa(Pa). Methods The plasmid pET-AiiA was cutted by Nhe Ⅰ and Xho Ⅰ , then the AiiA fragment was cloned into eukaryotic expression vector pEGFP-N2. After the plasmid was transfected into A549 cells, the protein was extracted and AiiA protein was found in it by Western blot. After the extrac- tion was admixed into the LB broth, from culture supernatant extracts of Pa, the N-acylhomoserine lactone (AHL) was detected by bioassay, and the expression of pyocyanin and elastase were assayed by RT-PCR and optical density. Results The fragment of AiiA gene was cutted and then cloned into pEGFP-N2. AiiA protein was found in the transfected cells. After admixed with the extract harboring AiiA protein, in Pa medium, the AHL was hydrolyzed, and the expression of pyocyanin and elastase were reduced. Conclusion The virulence factors synthesized by Pa were reduced by the AiiA protein expressed in eukaryotic cell.

Previous studies proposed that the synergistic effect of fibroblast growth factor-21 (FGF-21) and insulin may be due to the improvement of insulin sensitivity by FGF-21. However, there is no experimental evidence to support this. This study was designed to elucidate the mechanism of synergistic effect of FGF-21 and insulin in the regulation of glucose metabolism. The synergistic effect of FGF-21 and insulin on regulating glucose metabolism was demonstrated by investigating the glucose absorption rate by insulin resistance HepG2 cell model and the blood glucose chances in type 2 diabetic db/db mice after treatments with different concentrations of FGF-21 or/and insulin; The synergistic metabolism was revealed through detecting GLUT1 and GLUT4 transcription levels in the liver by real-time PCR method. The experimental results showed that FGF-21 and insulin have a synergistic effect on the regulation of glucose metabolism. The results of real-time PCR showed that the effective dose of FGF-21 could up-regulate the transcription level of GLUT1 in a dose-dependent manner, but had no effect on the transcription level of GLUT4. Insulin (4 u) alone could up-regulate the transcription level of GLUT4, yet had no effect on that of GLUT1. Ineffective dose 0.1 mg kg(-1) FGF-21 alone could not change the transcription level of GLUT1 or GLUT4. However, when the ineffective dose 0.1 mg x kg(-1) FGF-21 was used in combination with insulin (4 u) significantly increased the transcription levels of both GLUT1 and GLUT4, the transcription level of GLUT1 was similar to that treated with 5 time concentration of FGF-21 alone; the transcription level of GLUT4 is higher than that treated with insulin (4 u) alone. In summary, in the presence of FGF-21, insulin increases the sensitivity of FGF-21 through enhancing GLUT1 transcription. Vice versa, FGF-21 increases the sensitivity of insulin by stimulating GLUT4 transcription in the presence of insulin. FGF-21 and insulin exert a synergistic effect on glucose metabolism through mutual sensitization.

Objective To investigate the characteristics on the time of sunshine exposure in Chinese primary and middle school students.Methods A total of 43 771 primary and middle school students were randomly selected from 12 provinces in China.A self-reported questionnaire was used to understand their time of sunshine exposure on weekdays and weekends as well as related family information and behaviors.x2 test was used to compare the hours of sunshine exposure among different groups.Multivariate logistic regression analysis was conducted to identify the influencing factors.Results Results from the current survey indicated that the average time of sunshine exposure on weekdays and weekends were 2.49 and 3.22 hours,respectively.On weekdays,proportions of students with time of sunshine exposure ≤2 h/d or ＞2 h/d were 60.81％ and 39.19％,respectively.On weekends,the proportions became 44.05％ and 55.95％,respectively.On weekdays,the time of sunshine exposure as ≤2 h/d was significantly different among factors as sex,urban or rural area,residential area,self-rating academic performance,type of housing or ways of commuting to school.On weekends,the time of sunshine exposure ≤2 h/d were significantly different among sex,residential areas,self-rating academic performance,type of housing and ways of commuting to school.Data from the multivariate logistic regression analysis showed that the limited sunshine exposure was significantly associated with factors as:type of primary schools,being girls,students living in the urban area or living in central or western areas,with normal or better academic performances,living in a fiat apartment and the time spent on watching video program ＞2 h/d both on weekdays and weekends.Conclusion The time of sunshine exposure seemed not enough among school students and significant differences were seen among different groups.

Objective To summarize our clinical experience of cryoablation for renal cancer and to analyze the therapeutic indication,security,selection of cryoablation and outcomes.Methods Sixty-four patients suffered with T1a renal cell carcinoma were enrolled in this study from March 2012 to March 2018.Among them,5 cases were senile patients (≥ 80 years),5 cases complicated with other cancers,3 cases complicated with renal insufficiency,4 cases complicated with decompensated cirrhosis,3 cases with bilateral renal cancer,4 cases with solitary kidney cancer and 39 cases with some other complications.The preoperative serum creatinine level was(80.5 ± 38.2)μmol/L.The patients underwent laparoscopic singlesite (LESS) renal cryoablation,conventional laparoscopic renal cryoablation,or percutaneous image-guided cryoablation according to individual situation.Contrast-enhanced CT scan or MRI were used during the procedures and follow-up was performed.Results All operations were completed successfully and technical success was achieved as well in all cases.Blood transfusion was necessary for 2 cases because of hemorrhage.The mean diameter of the mass was (2.6 ± 0.90) cm,the median volume of blood loss was 50ml(10-110 ml),and the mean operation time was(96.0 ± 24.5) min.The median inpatient hospital stay was 3 d (1-6 d).In one case,digital subtraction angiography (DSA) embolization was performed due to hemorrhage after surgery.None of the other cases had intraoperative or postoperative complications.The serum creatinine level after surgery was not significantly decreased [postoperative (83.8 ±42.1) μmol/L,P =0.64].The contrast-enhanced CT or MRI of the kidneys one week postoperatively showed uniform low density in all lesion areas,which represented complete ablation and regression of the tumor.All cases were followed up regularly.One case showed relapse at the 6 th month follow-up and underwent cryoablation again.Another case,who was not regularly followed up,relapsed at 69th month after surgery.No relapse was observed in the other cases during the follow-up.Conclusions Renal cancer cryoablation is a safe,feasible and efficacious therapy for the patients who suffered from unresectable T1a renal cell carcinoma because of high surgical risk or multifocal lesions.

Aural vertigo frequently encountered in the otolaryngology department of traditional Chinese medicine （TCM） mainly involves peripheral vestibular diseases of Western medicine， such as Meniere's disease， benign paroxysmal positional vertigo， vestibular neuritis， and vestibular migraine， being a hot research topic in both TCM and Western medicine. Western medical therapies alone have unsatisfactory effects on recurrent aural vertigo， aural vertigo affecting the quality of life， aural vertigo not relieved after surgery， aural vertigo with complex causes， and children's aural vertigo. The literature records and clinical practice have proven that TCM demonstrates unique advantages in the treatment of aural vertigo. The China Association of Chinese medicine sponsored the "17th youth salon on the diseases responding specifically to TCM： Aural vertigo" and invited vertigo experts of TCM and Western medicine to discuss the difficulties and advantages of TCM diagnosis and treatment of aural vertigo. The experts deeply discussed the achievements and contributions of TCM and Western medicine in the diagnosis and treatment of aural vertigo， the control and mitigation of the symptoms， and the solutions to disease recurrence. The discussion clarified the positioning and advantages of TCM treatment and provided guidance for clinical and basic research on aural vertigo.