Objective To analyze the complications and short-term effects of laparoscopic surgery for achalasia.Methods The clinical data of 41 patients with achalasia who were treated by laparoscopic surgery were analyzed retrospectively.Results The 41 patients were no deaths.All patients underwent Heller cardiomyotomy and fundoplication,39 patients with Dor anterior fundoplication,2 patients had the presence of hiatal hernia with Toupet fundoplication.The mean surgical time was 142 min.Intraoperative complications occurred in 7 cases,including 6 cases of mild complications.The mean follow-up was 21 months.The clinical efficacy excellent in 27 cases,good in 7 cases,generally in 5 cases,poor in 2 cases.Conclusions Heller cardiomyotomy should be the treatment of choice in achalasia patients,because of its short and medium term outcomes,and its low morbidity.

Objective To observe the clinical effect of procedure for prolapse and hemorrhoids (PPH) in treating hemorrhoids.Methods 78 patients with symptomatic Ⅱ,Ⅲ and Ⅳ degree hemorrhoids undergoing PPH were selected in this study.The diagnosis,medical history,operative time,blood loss and perioperative complications were recorded.The World Health Organization Quality of Life Scale(WHOQOL-BREF) was observed preoperation and 6 hours,24 hours,1 month postoperation.Results The postoperative pain score measured by visual analogue scale (VAS) at postoperative six hours was (7.6 ± 2.1),which reduced to (1.3 ± 1.1) at 24 hours.There was significant improvement in the overall perception of QOL,health,and in physical and psychological domains (t =1.901,1.805,1.714,P =0.041,0.038,0.029,all P ＜ 0.05).There was modest improvement in environmental domain,while no change was found in social domain (P ＞ 0.05).Conclusion PPH surgery achieves good clinical results,improved quality of life of patients,with a low incidence of complications,patients with hemorrhoids should be recommended for this preferred surgical approach.

Objective To investigate the relationship between the 5-lipoxygenase(5-LO) in mouse lung and during infection in the respiratory system.Methods Investigate the expression of 5-LO in the lung of a mouse by immunocytochemistry.Results The intensity of the immune staining against 5-LO antibody was stronger in infected mice than that in non-infected rats.A weaker immuneoreation was observed in the treated group of animals.Conclusion Changes in the expression of 5-LO in pulmonary tisssues could be designed to detect the treatment efficacy during the lung infection.

Objective To investigate the effects of exogenous wild DCC gene stably transfection on growth of colorectal carcinoma cell line SW1116 in vitro. Methods DCC gene domain was amplified from human normal colon tissue by reverse transcript-polymerase chain reaction(RT-PCR). At first,a recombinant expression plasmid pcDNA3. 1( + )-DCC was constructed. Human colorectal carcinoma cell line SW1116 with-out DCC gene was transfected with pcDNA3. 1-DCC. Cell viability was tested by methyl thiazolyl tetrazolium (MTT)assay. Immunofluorescence staining was used to determine the effects of pcDNA3. 1-DCC and expres-sion of carcino-embryonic antigen(CEA)in human colorectal carcinoma cell line SW1116 which was transfect-ed with pcDNA3. 1-DCC. Results The population of cells transfected with pcDNA3. 1( + )-DCC plasmid was lower than those with pcDNA3. 1( + )-DCC plasmid and normal cells(t = 3. 645,P ﹤ 0. 05;t = 3. 132,P ﹤0. 05)at 3 ~ 6 days after transfection,and the proliferation rate of cells transfected with pcDNA3. 1( + )-DCC plasmid was lower than those with pcDNA3. 1( + )plasmid and normal cells(t = 2. 134,P ﹤ 0. 05;t = 2. 736, P ﹤ 0. 05). Cell line SW1116 transfected with pcDNA3. 1( + )-DCC plasmid total viability was lower than nor-mal cells(t = 3. 053 ,P ﹤ 0. 05)at 2 ~ 6 days after transfection. Cell line SW1116 transfected with pcDNA3. 1 ( + )-DCC plasmid total viability was lower than those with pcDNA3. 1( + )plasmid(t = 2. 816,P ﹤ 0. 05)at 2,4,5,6 days after transfection. The population of flavo-green colour cells transfected with pcDNA3. 1( + )-DCC plasmid and the fluorescent intensity of these cells were lower than those with pcDNA3. 1( + )plasmid and normal control cells. Conclusion Transfected DCC gene can suppress the cell proliferation and make CEA expression of cell line SW1116 down regulation to weaken its infiltration and metastasis abilities.

Objective: To compare the effects of pericardium patch aortoplasty and pulmonary patch aortoplasty for treating the infants with aorticcoarctation (AC) combining hypoplastic aortic arch in order to provide a better surgical choice in clinical practice.
Methods: A total of 57 patients with AC combining hypoplastic aortic arch treated in our hospital from 2009-01 to 2014-12 were retrospectively studied. The patients were divided into 2 groups: Pericardium patch aortoplasty group,n=26 and Pulmonary patch aortoplasty group,n=31. The changes of the pressure gradient at post-operation and follow-up period were compared.
Results: There were 2/57 (3.5%) patients died, 1 in Pericardium patch aortoplasty group by pulmonary hypertension crisis, the other 1 in Pulmonary patch aortoplasty group by respiratory distress syndrome. No renal failure or neurological complication occurred in neither groups. The cardiopulmonary bypass time, aortic clamping time, ventilator time and ICU stay time were similar between 2 groups,P>0.05. Selective cerebral perfusion time in Pericardium patch aortoplasty group was shorter than Pulmonary patch aortoplasty group (30.5 ± 8.6) s vs (35.6 ± 10.3) s,P<0.05. By ultrasound estimation, the post-operative AC pressure gradients were decreased than they were before, as in Pericardium patch aortoplasty group (9.5 ± 7.5) mmHg vs (39.9 ± 15.5) mmHg and in Pulmonary patch aortoplasty group (11.8 ± 11.3) mmHgvs (39.2 ± 14.5) mmHg, bothP<0.05; while post-operative pressure gradients were similar between 2 groups,P>0.05. Follow-up study was conducted in 51 patients for (17.6 ± 16.6) months, Pericardium patch aortoplasty group had 6 patients with re-stenosis, 3 of them would receive balloon angioplasty and 3 would be continuously followed-up; Pulmonary patch aortoplasty group had 6 patients with re-stenosis, 2 of them ifnished balloon angioplasty and their pressure gradients were obviously decreased, 4 would be continuously followed-up. Kaplan-Meier curves presented that Pulmonary patch aortoplasty group was superior to Pericardium patch aortoplasty group in re-stenosis occurrence during follow-up period.
Conclusion: Both pericardium patch aortoplasty and pulmonary patch aortoplasty were effective for treating the patients with AC combining hypoplastic aortic arch, the early post-operative efifcacy was similar, while the mid-term follow-up result was better in pulmonary patch aortoplasty.

Objective To evaluate the efficacy of solifenacin with or without tamsulosin in patients with overactive bladder (OAB).Methods Fifty-three patients with OAB were randomly divided into two groups (group A 27 patients, group B 26 patients).The patients received either solifenacin 5 mg/day in group A or combined with Tamsulosin 0.2 mg/day in group B for two weeks.During the treatent period all the patients recorded voiding and adverse events in a diary.The symptoms of urgency, frequency, incontinence were evaluated by OABSS scores at the begining and end of the therapy period.The results of the efficacy and safety were analyzed by using SPSS 13.0.Results The OABSS scores at the begining and end for the two groups were significantly different ( P ＜ 0.01 ).In both groups the efficacy was obvious.The OABSS scores at the end of the therapy between group A and B were significantly different (P ＜0.05 ).The efficacy of group B was better than that of group A.Conclusion The efficacy of solifenacin combined with tamsulosin was better than solifenacin alone in OAB.

Objective To evaluate and compare the efficacy and safety of laparoscopic surgery in the treatment of elder colorectal cancer patients.Methods Selected the retrospective or prospective studies which were retrieved in Pubmed,web of Science,Embase as laparoscopic,laparoscopic colectomy,colorectal cancer,rectal cancer,octogenarian,elderly published between Jan.2000 and May 2017.Data regarding operative indexes,postoperative complications and long term outcomes were analyzed by Stata12.0 software.Results A total of 18 articles,included 3 162 patients,were enrolled in this study.The Meta-analysis indicated that there were no significant differences of less blood loss,postoperative wound infection,bowel obstruction and cardiovascular complications in laparoscopic surgery group except the operative time (P ＜ 0.05).No significant difference was found in the number of dissected lymph node,pneumonia,overall survival and disease free survival (P ＞ 0.05).Conclusion With advantages of rapid postoperative recovery and fewer complications,laparoscopic radical resection for colorectal cancer in elderly patients is safe and effective.

Objective To investigate the association between DNA methylation of matrix metallo-proteinase 9(MMP-9) gene and cognitive function including continuous attention,cognitive flexibility and visuospatial memory in patients with chronic schizophrenia.Methods 71 male schizophrenia patients and 69 healthy controls were recruited and detected their cognitive function.Pyrosequencing was used to determine DNA methylation at CpG site in exon 4 and exon 5 of MMP-9 gene.RT-qPCR was used to detect MMP-9 gene expression.Clinical symptoms were assessed by BPRS.Results (1) Cognitive function including Trail Making Test A,Trail Making Test B,Stroop words only,Stroop colors only,Stroop interference,Spatial Processing Block design and Block Design all scores were significantly lower in schizophrenia patients with schizophrenia than those in health controls (P＜0.01);(2) The MMP-9 gene expression in PBMCs was significantly higher in schizophrenia patients (1.31± 0.48) than that in health control (1.11 ± 0.45,P＜ 0.05).The DNA methylation of CpG4-1,CpG4-2,CpG4-3,CpG4-4,CpG4-5,CpG5-1,CpG5-2,CpG5-4 of MMP-9 gene in schizophrenia patients were lower than those in health controls (P＜0.01).(3)DNA methylation of CpG4-3 was positive correlated with Stroop interference (r=0.324,P＜0.01) in health controls.Correlation analysis showed that DNA methylation of CpG4-1 was negatively correlated with sustained attention function (r =-0.329,P＜0.01),cognitive flexibility (r =-0.337,P＜ 0.01) and visuospatial memory (r =-0.308,P＜ 0.05) in schizophrenia patients.There were positive correlations between DNA methylation of CpG4-5 (r=0.305,P＜0.05),CpG5-1 (r=0.262,P＜0.05),CpG5-3 (r=0.260,P＜0.05),average DNA methylation at exon 5 (r=0.288,P＜0.05) and visuospatial memory.DNA methylation of CpG5-4 was positive correlated with sustained attention function (r=0.251,P＜0.05) and visuospatial memory (r=0.350,P＜ 0.01) respectively.Conclusion Male patients with schizophrenia suffer from extensive cognitive impairment,and methylation of MMP-9 gene may be associated with cognitive impairment of schizophrenia.

Objective:To examine the expression of programmed cell death 1 (PD-1) and its ligand (PD-L1) in epithelial ovarian cancer (EOC) tissues, and investigate the correlation among their expression, clinicopathological features and prognosis.Methods:The specimens of 180 patients with EOC treated in the First Affiliated Hospital of Dalian Medical University from October 2002 to December 2013 were confirmed by pathological examination. The pathological tissue specimens of subtypes ，included 120 cases of serous carcinoma, 30 cases of mucinous carcinoma, 20 cases of endometrioid carcinoma, and 20 cases of clear cell carcinoma. The normal paracancerous tissues of 50 cases randomly selected from the 180 patients as control group. Immunohistochemical SP method was used to detect the expressions of both PD-1 and PD-L1 in epithelial ovarian cancer tissues, and the relationships among their expressions,the clinicopathological parameters and prognosis were respectively analyzed.Results:（1） PD-1 was expressed in lymphocytes infiltrated in EOC tissues, and PD-L1 was expressed in the cell membranes of cancer tissues. In all EOC cases, 33 cases (18.3%, 33/180) of both PD-1 and PD-L1 were highly expressed, and only 1 (2.0%, 1/50) of control group showed high expression. There was statistically significant difference between two groups ( P<0.01). (2) Among the four subtypes tissue specimens of EOC, the high expression rate of PD-1 was 25.0% (30/120) for serous carcinoma, 3/15 for endometrioid carcinoma, 0 (0/30) for mucinous carcinoma, and 0 (0/15) for clear cell carcinoma. The high expression rate of PD-L1 was 23.3% (28/120) for serous carcinoma, 3.3% (1/30) for mucinous carcinoma, 2/15 for endometrioid carcinoma, and 2/15 for clear cell carcinoma. Both PD-1 and PD-L1 expressions in the four sub-types of tissue specimens were significantly different ( P<0.05). The high expression rate of both PD-1 and PD-L1 was 9.2% (8/87) in the early stage and 26.9% (25/93) in the late stage. There was a statistically significant difference between the two groups ( P<0.01). Similarly, the expression of both PD-1 and PD-L1 were significantly higher in the cases of high-grade EOC （type Ⅱ） than those of low-grade （type Ⅰ） and in the cases of EOC distributed bilaterally than that distributed unilaterally, and there were statistically significant differences ( P<0.05). (3) The Kaplan-Meier survival analysis showed that the survival time were respectively 35 and 36 months in the cases with high expressions of both PD-1 and PD-L1, and the survival time were the same as 61 months in the cases with low expression of both PD-1 and PD-L1, and the comparison was statistically significant ( P<0.05). Conclusions:The expression levels of PD-1 and PD-L1 in EOC tissues are higher than those in adjacent tissues, especially in serous carcinomas. The expression of both PD-1 and PD-L1 is higher in specimens of the patients with advanced stages. The results showed that the high expression of both PD-1 and PD-L1 is an indicator of poor prognosis of patients suffering from EOC.