Whether resection for colorectal cancer could achieve the same effect as open surgery had been doubted. Recently, the international large prospective random control tests and large retrospective studies have revealed that laparoscopic resection for colorectal cancer not only has short-term advantages such as minor injuries, less postoperative pain, quicker recovery of bowel function and less postoperative hospital stay, but also had at least the equivalent long-term effects in local recurrence, distant metastasis, incision implantation and long term survival. It is promising that the roll of laparoscopic surgery for colorectal cancer will be defined by more evidence-based medicine study in the near future.

The author first analyses the developing tendency of international higher education in 21 century whichbrings some challenges, such as popular target, varied pattern, and so on; then advances 6 pieces of correspondingcountermeasures:narrowing the gap between supply and demand,optimizing the structure of admimstrative offices,rear-ranging the disposition of resources, standardizing the management system,carrying out the distinctive strategies andgoing right into the international market.

Objective To summarize our experience in treatment of distal radius fracture by T-shaped plate internal fixation combined with external fixation.Methods Nine cases of unstable fracture of distal radius were included.There were two cases of type B and seven cases of type C according to AO classification.They were all treated by T-shaped plate fixation combined with external fixation.Autogeneic bone grafting was applied in eight patients.All the nine cases were followed up to evaluate their wrist joint range of active motion and radiographic parameters including palmar tilt,dorsal tilt,radial inclination,radial length and ulnar variance.Results All the patients were followed up for 6 to 1 2 months postoperatively(mean eight months).Anatomical reduction was achieved in all the cases.Delayed union or non-union was not observed.According to the rating scale of Gartland and Werley,eight cases got excellent results and one case good results.By the time of last follow-up,no such complications as pin hole infection,loosening of internal fixation,loss of reduction,tendon rupture or irritation occurred.Conclusion T-shaped plate fixation combined with exter nal fixation is reliable and effective in treatment of unstable fracture of distal radius.

Objective To observe the effect of anxiety and depression on cell adhesion molecules and fibrolytic activity in cardiac-pacing patients. Methods The levels of plasma P-selectin, E-selectin, sICAM-1, vWF and PAI-1 were measured in 39 cardiac-pacing patients with anxiety or depression as rersearch group, 32 cases cardiac-pacing patients without any psychological problems as observation control group and 20 healthy subjects as normal control group. Result The levels of plasma P-selectin, E-selectin, sICAM-1, vWF and PAI-1 in cardiac-pacing patients were significantly higher than those in normal control group, and their plasma levels in the patients with anxiety or depression were significantly higher than those in the patients without psychological problems. Conclusion There were significantly elevated cell adhesion molecules level and decreased fibrolytic activity in cardiac-pacing patients. The anxety and depression status could aggregate this condition.

Objective To study the clinical characteristics of atlanto-axial dislocation and instability caused by different reasons. Methods 388 cases of atlanto-axial dislocation and instability admitted between Jan 1975 and Apr 2000 were reviewed retrospectively. Results 262 cases were caused by anomaly, 71 by trauma and 55 by other reasons. 238/262 had bony deformity, including anomaly of odontoid process, atlanto-occipital assimilation, skull basilar invagination and some others. Simple anomaly of odontoid was the most commonly seen etiology. Myelopathy occurred at similar morbidity among each kind of patients. But patients who presented symptoms for longer time were more likely to have myelopathy. It is difficult to reduce chronic fractures of the odontoid process compared with the fresh fractures. 19 cases with chronic fracture suffered from severe myelopathy. Patients with chronic atlanto-axial fracture over 1 year were more likely to have secondary damage of spinal cord than those within 1 year. Conclusion Atlanto-axial dislocation and instability is more commonly caused by anomaly than trauma. Once the patients with atlanto-axial anomaly present clinical signs, they should be treated as soon as possible. Traumatic atlanto-axial instability should be treated at the early stage to avoid myelopathy.

Objective:To observe the clinical effect of Desensitizer Oravive combined Er:YAG laser irradiation on dentin hypersen-sitivity.Methods:240 molars in 86 patients with dentin hypersensitivity were divided into 2 groups(n =1 20).In control group De-sensitizer Oravive was applied to the teeth surface for 30 s;in combination group the teeth surfaces were treated by Er:YAG laser irra-diation for 60 s,and then by Desensitizer oravive for 30 s.Each tooth was treated only once.Pain and pain relief were evaluated by VAS before treatment and immediately,4,8 and 1 2 weeks after treatment.Data were statistically analyzed.Results:Before treat-ment,VAS showed no significant difference between the groups(P >0.05).Both groups exhibited lower VAS after treatment(P <0. 05),VAS values were lower(P <0.05)and the effective rate was higher in the combination group than those in the control group at each treatment stage(P <0.05).Conclusion:Desensitizer Oravive combined with Er:YAG laser is more effective than Desensitizer Oravive in the treatment of dentin hypersensitivity.

Objective To explore a novel operative management for irreducible atlantoaxial dislocation. Methods Fifty-four patients, which as 32 males and 22 females aged from 7 to 63 years old with a mean of 32 years, were diagnosed with irreducible atlantoaxial dislocation, including 18 patients with os odontoideum, 22 occipitalization, 5 malunion of odontoid fracture and 9 relaxation of transverse ligament of atlas. Forty patients presented signs and symptoms of myelopathy or spinal cord injury. All of the patients underwent the operation of open reduction and release by transoral approach. The longus collies muscles, longus capitis muscles, anterior longitudinal ligament, atlantoaxial articular capsules, the apical odontoid ligament and alar odontoid ligaments may be included, were transected, followed by arthrodesis via posterior approach in one stage. Different methods of posterior arthrodesis were conducted as followed: C1,2 transarticular screw fixation in 5 cases, occipitocervical fixation using pedicle screws of axis and occipitocervical plate in 37 cases, and C1,2 joint fixation with plates and screws in the lateral masses of the atlas and axis in 12 cases. Results A complete reduction was achieved in 41 cases, and the other 13 patients obtained partial reduction. Forty-eight patients were followed up from 4 to 40 months, 15.7 months at the average. All of them achieved solid arthrodesis. According to Odom's scoring system, among the 38 patients with preoperative upper cervical myelopathy, 15 patients were assessed as excellent, 14 good, 8 fair and 1 poor. During the operation, cerebral spinal fluid leakage occurred in 1 case, and pedicle screwing failed in 1 case. After the operation, respiratory failure was found in 1 case, nasal sound in 3 cases, dysphagia in 1 case. One patient became quadriplegia due to myelitis caused by septicemia at two weeks after the operation. The internal fixation loosened in 1 case at 2 months postoperatively. Conclusion Transorally surgical release for reduction and posterior arthrodeses could achieve satisfactory outcomes in patients with irreducible atlantoaxial dislocation.