Objective To analyze the application value of side way lymph node cleaned up in the low order rectal cancer operation. Methods 45 cases were randomly divided into two groups:first group was 30 cases, they were used the side way lymph node cleaned up of the rectal cancer broadens the curing once and for all skill;second group was 15 cases,they were used traditional rectal cancer curing once and for all skill. Results 7 cases of 1 group happen the side way lymph nodes transfer,the rate of transform was 23. 33% ,that low disintegration gland cancer and mucus gland cancer happen the rate of the side way lymph nodes transfer was beyond one-fold much than hight and middle disintegration gland cancer( P＜0. 05 ) ,the divergence is obvious. The operation time and amount losing blood of two group is not obvious, but first group's 3 years living rate was more higher than second group. Conclusion To the low order rectal cancer case sufferer that the side way lymph node cleaned up, may cut down the pelvic cavity recurs,obviously improve the living quality,lift the living rate,it has clinical practice value.

Objective To detect the expressions of VEGF and nm23 in non-small cell lung cancer (NSCLC) tissues and their relationships,and explore their clinical value in the diagnosis and treatment.Methods lmmunohistochemistry(SP method) was used to detect the expressions of VEGF and nm 23 in NSCLC and peritumor tissues.Results The positive expression rate of VEGF in NSCLC(63.3 ％,38/60)was significantly higher than in the peritumor tissues(16.7 ％,10/60)(x2=27.22,P＜0.01).nm 23 is on the contrary (53.3 ％,32/60)(x2=17.79,P＜0.01).The positive expression of VEGF in NSCLC was positively correlated significantly with the lymph node metastasis and histological classification(P＜0.05).The positive expression of nm 23 in NSCLC was negative correlated significantly with lymph node metastasis,P＜0.01.2-year survival rate of the VEGF-positive patients was significantly lower than that of VEGF-negative patients,and nm 23 is on the contrary(x2=5.55,P＜0.05).No correlation was found between the expressions of VEGF and nm 23 in NSCLC (x2=1.83,P＞0.05) Conclusion The VEGF and nm 23 may be closely associated to carcinogenesis and progression of NSCLC.Detection of VEGF and nm 23 are beneficial to indicate the biologic behavior of NSCLC.It has positive effect on diagnosis and treatment of NSCLC.

Objective To study plasma coagulation factor Ⅶ effects of intracerebral hemorrhage in patients with craniocerebral injury.Methods 120 cases of patients with traumatic brain injury were treated,for patients admitted to hospital,the hospital after 24 hours,48 hours of live clotting enzyme activation part (APlT),peripheral venous blood specimen testing international standardization ratio (INR)and the activity of platelet and F Ⅶ were detected.According to the intracranial bleeding lesions was expanded or the emergence of a new bleeding lesions,and so on and so forth were divided into research group and the control group,43 patients in the research group,77 cases in the control group.Results The study showed that the two groups of patients with injury to the first CT time, subarachnoid hemorrhage,epidural hematoma,there were no significant difference between the indexes of subdural hematoma,patients in the study group lost 48h PPSB was (653.2 ±489.8)IU,platelet (180.7 ±63.5)mL,plasma (582.7 ±411.3)mL and red blood cells (612.3 ±490.1)mL,which were higher than those of the control group [(465.7 ±278.8)IU,(0.0 ±0.0)mL,(335.1 ±261.9)mL,(378.3 ±46.3)mL],there were statistifically significant differences between the two groups(t =2.399,2.388,2.582,3.231,P =0.020,0.022,0.010,0.001), the platelet and F Ⅶ of the research group were (101.43 ±41.85)×109 /L,(93.04 ±20.98)%,which were lower than those of the control group[(128.37 ±51.49)×109 /L,(107.67 ±20.25)%],there were statistifically significant differences between the two groups(t =2.583,2.893,P =0.010,0.004).Conclusion Lower levels of platelet activity and F Ⅶ of closely associated with intracranial hemorrhage in patients with craniocerebral injury,according to the clinical indicators to predict whether patients with intracranial hemorrhage,in order to for the treatment of patients with timely and accurate to ensure the patient's life and health.

Objective To introduce a surgical method for treatment of severe gynecomastia.Methods After designing double rings and ectomizing epidermis between two rings,a supra-medialis derma mammary pedicle of the nipple and areola was formed,most of the gland and fatty tissue was ectomized,the pedicle was fixed with the sarcolemma,and the two rings were sutured together.Resuits There were no severe postoperative complications.Following-up of 9 cases (18 sites) for 6 to 24 months showed symmetrical and satisfactory contour.Conclusions The breast reduction with doublering supra-medialis pedicle can be an effective procedure of severe gynecomastia,in which the supramedialis pedicle can ensure the blood supply of nipple and areola and avoid late mastoptosis.

Objective To investigate the efficiency, safety and application value of early utilization of nutrient of home-made formula in post-operation of gastric fundic cardia cancer patients. Methods One hundred and forty-five cases of gastric fundic cardia cancer patients were randomly divided into two groups,early enteral-intestinal nutrient formula of home-made (enteral-intestinal group,73 cases) and intra-venous nutrition (intra-venous group,72 cases). Patients in enteral-intestinal group were given home-mada nutrition-liquid plus nutrison fibre for 6-8 days from the first post-operation day, intravenous group were given venousnutrition injection for 6-8 days from the first post-operation day. The average residential day, spends,complications and recovery situation were recorded and compared between the two groups. Results The average residential day in enteral-intestinal group was less than that in intra-venous group, average spends /drugs cost were (9433.1±1024.6)/(3271.8±420.9) yuan vs (12 953.4±2919.7 )/(4832.9±872.6) yuan respectively (P < 0.01 ),the complication in enteml-intestinal group was less than that in intra-venous group (P < 0.01 ). Time of revive testinal function in enteral-intestinal group was earlier than that in intra-venous group,ALB in enteral-intestinal group was higher than that in intra-venous group (P < 0.01 ). Conclusion Early enteral-intestinal nutrient utilization of home-made formula in post-operation of gastric fundic cardia cancer patients is safe and applicable, it can improve patients' post-operation nutrition situation and intestinal function.

Objective To study the clinical effectiveness of low cut and five dissector thyroidectomy to treat hyperthyroidism.Methods 337 cases of hyperthyroidism were randomly divided into study group(low cut and five dissector technique,223 cases) and control group(traditional technique,114 cases) according to the ratio of two:operating time,bleeding,complications,recur were compared between these two groups.Results The operating time of the study group and control group were(66.33?25.11)min and(121.27?42.35)min(t=12.75,P0.05).The rate of recurrence was marked(P

Objective To compare the stability effect of the fixation segment using the new test system based robotics to simulate the complex human movement at natural state about the three-level fixa-tion by using four, five or six pedicle screws in treatment of thoracolumbar burst fractures. Methods Six human cadaveric spines were dissected from T_(11)-L_3. The inferior half part of L_1 vertebral bodies and L_1-L_2 dises were resected to mimie an unstable L_1 burst fracture with loss of anterior column support. Specimens were tested in accordance with the following order:intact, 4,5 and 6 pedicle screws fixation at the three-level fixation. The range of motion (ROM) of the fixation segment (T_(11)-L_3) was measured with the six-freedom degree robotics system controlled by mixed force and displacement during flexion, exten-sion, lateral bending and axial torsion, when the stiffness was calculated. One-way statistieal analysis was used for analyzing the collected data. Results With increased number of screws, the ROM of the fixa-tion segment (T_(11)-L_3) was gradually decreased and the stiffness gradually increased. The ROM under ax-ial rotation of six and five screws group became smaller than four screws group (P < 0.05). The stiffness under axial rotation of six screws group was higher than four screws group (P < 0.05). There was no sta-tistical difference between five screws group and four screws group in regard of the stiffness in axial rota-tion (P > 0.05). There were no significant differences in ROM and stiffness under six different loading directions between six screws group and five screws group (P > 0.05). No statistical difference was observed for three fixation modes in aspects of ROMs and stiffness under flexion-extension or lateral ben-ding (P > 0.05). Conclusions Three-level fixation of burst fractures with five or six screws offers im-proved biomechanical stability compared with traditional four screws fixation. But the difference is insig-nificant between six and five screws fixations.

Objective To investigate the alteration of C/EBP α,C/EBP β and endoplasmic reticulum stress (ERS) related molecules (IRE1α and sXBP1) expression in pancreatic tissues in rats with hypertriglyceridemia related acute pancreatitis.Methods Ninety six Sprague Dawley (SD) rats were divided into 4 groups:control group,hypertriglyceridemia (HTG) group (n =24,fed with high fat diet for 2 weeks),AP group (n =24),HTG + AP group (n =24),and AP was induced by peritoneal injection of cerulein.The rats were sacrificed at 3,6,9,24 h after AP induction,respectively.The pathological changes of the pancreatic tissues were observed and scored by HE staining.Plasma levels of IL-1β,IL-6 and TNF-α were measured by ELISA.The expression of IRE1α,sXBP1,C/EBPoα,C/EBPβ mRNA were analyzed by real time PCR.The expressions of IRE1α,sXBP1,NF-kB,C/EBPα and C/EBPβ protein were determined by Western Blot.The expressions of C/EBPα and C/EBPβ proteins were also determined by immunohitochemistry.Results After two weeks of high fat diet,serum levels of triglyceride(TG) and total cholesterol (TC) in HTG group,HTG + AP group were much higher than those of the control group,and the difference was statistically significant (P ＜ 0.05).The pancreatic tissue injury was more severe in HTG + AP group,particularly at 9 h (P ＜ 0.05).And plasma IL-1β,IL-6 and TNF-α levels were also much higher in HTG + AP group when compared with that of AP group,the differences were all significant at 9 h (P=0.011;P=0.034;P =0.027).After AP induction,IRE1,sXBP1,C/EBP and C/EBPβ mRNA began to be up-regulated at 3 h,and IRE1 mRNA reached the highest level at 24 h,sXBP1 mRNA at 9 h,while C/EBP and C/EBPβ mRNA reached the highest level at 6 h.Compared with AP group,IRE1,sXBP1,C/EBP and C/EBPβ mRNA levels were much higher in HTG + AP group.In addition,as to IRE1 and sXBP1 mRNA,the difference was significant at 3,6,9,24 h,and C/EBP mRNA at 6,9,24 h,C/EBPβ mRNA at 6 and 9 h (P ＜ 0.05).After AP induction,IRE1α,sXBP1 and NF-kB proteins in the pancreatic tissue began to be up-regulated at 3 h,and all reached the highest level at 9 h.IRE1α,sXBP1 and NF-kB proteins were up-regulated more obviously in HTG + AP group,and the up-regulation in HTG + AP group was higher than that in AP group,and the high expressions of C/EBPα and C/EBPβ proteins could only be detected at 6 and 9 h in the HTG + AP group,while there was no expression detected in AP group.Conclusions C/EBPα,C/EBPβ,IRE1α and sXBP1 may be involved in the pathogenesis of HTG related AP,and IRE1α/sXBP1 pathway and C/EBPoα,C/EBPβ may mediate the pathologic injury and inflammation process of HTG related AP.

Objective To observe the early outcome and crisis onset after surgical treatment on myasthenia gravis with thymoma and analyze the relevant factors.Methods 436 patients with myasthenia gravis were treated surgically between January 1999 and Jan- uary 2005,58 patients with thymoma.The severity of MG disease was classified according to modified Osserman classification:type Ⅰ(n=17),type Ⅱ a(n=23),type Ⅱ b(n=12)and type Ⅲ(n=6).The distribution of thymomas by the Masaoka clinical stage showed 30 in stage Ⅰ,18 in stage Ⅱ,7 in stage Ⅲ and 3 in stage Ⅳ.The early outcome and crisis onset after surgical treat- ment were analyzed by statistical methods.Results After operation,symptoms improved in 16 eases(27.59%),no change in 18 eases(31.03%),deterioration in 11 cases(18.97%)and crisis onset or death in 13 cases.Logistic test showed that the possibility of crisis onset in patients with thymoma is 1.286 times higher than patients without thymoma.Patients with thymoma,type Ⅱ or above are in high risk group of crisis.The incidence rate of crsis in type Ⅱ group or above was significantly higher than type Ⅰ(P=0.048 0.05).Conclusion The risk of crsis onset after operation significantly raises in myasthenia gravis patients with thymoma.The staging of the disease are associated to development of crisis and crisis onset is independents to patho-staging of thymoma.

Objective To investigate the effects of carbachol on intestinal inflammation and mucosal blood flow after gut ischemia-repedusion(I/R) in rat. Method A jejunal sac was formed in Wistar rats. The superior mesenteric artery (SMA) was occluded for 45 mi-nutes followed by 240 minutes of reperfusion. Animals were random divided into three groups: sham operation, L/R + saline injection (I/R + NS) and I/R + carbachol injection (0.1mg/kg, I/R + Ca). Immediately after occluded of SAM blood flow, either 0.1mg/kg of carba-chol or same account of 0.9% saline was injected into the jejunal sac. The pathological injury was observed with HE staining. The activity of DAO and content of TNF-α in intestinal mucosa tissue were determined. Mucosal blood flow was measured by laser Doppler. All measure-ments were done at 0 min, 30 min, 60 min, 120 min, and 240 min after reperfusion. Result In I/R group the activity of DAO in intestinal mucosa and mucosal blood flow deceased, meanwhile the content of TNF-α gut tissue was dramatically increased than those in sham operation (P<0.01). Severe pathological changes were observed in intestinal mucosa. After injection of carbachol, the activity of DAO and mucosal blood flow increased (P<0.01), but the content of TNF-α in intestinal mucosa were dramatically decreased (P<0.01), compared with those in I/R group. Conclusion Administration of carbachol protects intestinal ischemia-reperfusion injury by attenuating intestinal mucosa inflammation and increasing gut mueosal blood flow.