Objective To muhi-directionally visualize and measure the normal anatomy of palatovaginal canal and its communications with high-resolution multi-slice spiral CT and its post-processing technologies.Methods One hundred and sixty-seven subjects with normal PPF and its communications were examined by 16-MSCT using high-resolution technique.The MPR and CPR images of palatovaginal canal were obtained on postproeessing workstation.The length and diameter of the palatovaginal canal and its communications was measured and analyzed with one way ANOVA analysis and independent samples t test.Results In this study, the detection rate of palatovaginal canal on 167 subjects was 98.8% (330/334).The mean length of left and right palatovaginal canal was (1.18 ± 0.22) cm and (1.07 ± 0.29) cm, respectively.The mean diameter of anterior opening (0.19±0.06)cm was significantly larger than median (0.10 ± 0.04) cm and posterior opening (0.16 ± 0.07)cm in left palatovaginal canal (F = 211.109, P < 0.01).Similarly,The mean diameters of anterior, median and posterior opening in right palatovaginal canal were (0.19±0.06)cm, (0.10±0.03)cm and(0.16±0.06) cm, respectively (F = 139.350,P <0.01).No significant difference on length measurements was revealed between the men [left: (1.18±0.22) cm; right: (1.12 ± 0.31)cm] and women [left: (1.07±0.25)cm; fight: (1.02±0.25)cm] (left: t = 0.919, P > 0.05 ;right:t = 1.117,P > 0.05).Between the men [left: (0.19±0.06) cm, (0.10 +0.04) cm and (0.16±0.07) cm; right: (0.19±0.06) cm,(0.10±0.04) cm,(0.16±0.06) cm] and women [left: (0.20±0.08) cm, (0.10±0.04) cm and (0.15±0.05) cm; right: (0.20±0.06) cm, (0.09± 0.04) cm and (0.15±0.05) cm], no significant difference on diameter measurements was revealed (left: t =- 1.183,0.190 and 1.660 ; fight: t = - 1.420,1.210 and 0.802 ; all P > 0.05).Conclusion On the basis of high-resolution MDCT scan, MPR and CPR images could visualize clearly the morphologic features of the palatovaginal canal, which may be helpful for making diagnostic and therapeutic decisions because more imaging information could be obtained.

OBJECTIVE To study the incidence of ?-lactamases,mainly the extended-spectrum beta-lactamases(ESBLs) and metallo-beta-lactamases(MBLs) of Chryseobacterium indologenes and Ch.gleum.METHODS Agar dilution method was applied to detect minimal inhibitory concentrations(MIC) to 12 different antibiotics used frequently.Three-dimensional test was used to detect ESBLs and metallo-?-lactamases.The genes of ?-lactamases were amplified with 3 pairs of primers special for Ch.indologenes and Ch.gleum.RESULTS Among the 25 strains of Ch.indologenes and 10 strains of Ch.gleum,68%(17/25) isolates of Ch.indologenes and 90%(9/10)isolates of Ch.gleum were considered as MBLs positive strains,but no isolates were detected for the production of ESBLs.CONCLUSIONS MBLs are the important mechanism of multi-drug resistance for Ch.indologenes and Ch.gleum.

Six patients with ST segment elevated acute myocardial infarction (AMI), who were 52.5 years old in average, were enrolled and performed the treatment at Tongren Hospital from November 2003 to June 2004. Following percutanecus transluminal coronary angioplasty and stent revascularization, autologous bone marrow stem cell (BMSC) transplantation was performed after informed consent was obtained. Patients were subcutaneously injected with granulocyte colony-stimulating factor (G-CSF) at 1 week before transplantation. When CD34+ cells going up to 1%-3% in peripheral blood, mononuclear cells in peripheral blood were harvested,purified, and further infused into the infarcted related coronary artery with an over-the-wire balloon catheter. Following up was performed every half a year. Four years later, the infarcted area of these patients was further decreased by 8.03%, in the basic descent of 42.7% at 3 months averagely; total infracted area descent was 50.73%, but ejection fraction increased by 4.6% from 50.8%. There was no serious coronary artery restenosis and/or stenosis formation which need revascularization upon angiography.

Objective To investigate the clinical characteristics and surgical treatment for primary presacral tumors.Methods The clinical data of 42 patients of primary presacral tumors from January 2013 to May 2015 were analysed retrospectively.Results Of the 42 patients,16 cases were asymptomatic while 26 patients had discomfort at the sacral or abdominal region,or difficulty in urinating or defecation.90％ of the cases were digital rectum examination (DRE) positive.Among the 42 patients 36 cases underwent surgical treatment,1 case underwent radiotherapy,5 cases refused surgical treatment.Among those receiving surgical resection,28 cases had trans-abdominal surgery and 4 cases had trans-sacral surgery,while 3 cases had trans-abdominal & trans-sacral surgery,1 case had trans-abdominal and perineal surgery.Tumors were completely resected in 31 cases,and palliatively resected in 5 cases.3 cases suffered from intra-operative presacral hemorrhage.1 case with delayed hemorrhage required surgical intervention.2 cases from incision infection recovered after wound disinfection and dressing.3 cases had postoperative hip or leg numbness;1 case with high fever was cured by intensive antibiotics treatment.Conclusion The low incidence of presacral tumors makes early detection difficult.A diagnosis can be obtained by a positive DRE combined with CT or MRI results.Resection is a therapy of choice after biopsies.

Objective To investigate the postoperative complication and nursing experience of hand-assisted laparoscopic J-type ileal pouch-anal anastomosis (IPAA) in familial adenomatous polyposis (FAP). Methods A total of 36 patients with FAP who had undergone hand-assisted laparoscopic J-type ileal pouch- anal anastomosis (IPAA) were analyzed retrospectively. Results The postoperative complication included ileal pouch bleeding in 2 cases, urinary retention in 3 female patients, external hemorrhoids swelling in 3 cases, and anastomotic fistula in 2 cases. Six cases had ileum pouch inflammation during the postoperative follow- up. All the complications were relieved after conservative medical therapy. Conclusions IPAA operation puts forward high technical requirements with more postoperative complications. Therefore, it is important to strengthen nursing of the patients, reduce postoperative complication and increase quality of life of FAP.

This is a retrospective study of 103 cases of early gastric cancer undergoing surgery during the years of 1974-1988 with a special discussion on surgical treatment.The lesions were localized to the mu-cosal layer in 54.3%,to submucosal layer in 45.7%,In 10% of patients there was lymphnode metastasis,all of them were in the first station.Operation consisted of radical subtotal gastrectomy in 94.2%.and total gastrectomy in 5.8%.The extent of lymphatic excision was:Ro in 12.6%,R1 in 61.2% and R2 in 26.2% Postoperative chemotherapy was given in 61.2%.However no statistical difference of 5 years survival rate was found in respect to the extent of lymphatic excision as well as postoperative chemotherapy.Since 60.2% of EGC lesions were of minute,multiple and plane type,preoperattve en-doscopy and intraoperative biopsy of gastric mucosa,if necessary,should be carefully done to ascertain that no lesion was overlooked in the remnant of the stomach.Follow-up rate was 96%,and the survival rates of 3 and 5 years were 97% and 93.7%.This makes the authors believe that a radical operation of R1 is justified and routine postoperative chemotherapy is unnecessary.

Objective:To analyze the clinical characteristics of primary acute myeloid leukemia (AML) (non-M3 type) in children suffering from different levels of platelet count(PLT).Methods:In the Tumor Hospital of Zhengzhou University from January 2014 to December 2018, laboratory and clinical data of 247 de novo primary AML pediatric patients were retrospectively reviewed.According to the PLT before treatment, patients were divided into very low platelet group (VLG), low platelet group (LG) and non-lowing platelet group (NLG), with<50×10 9/L, ≥50×10 9/L but <125×10 9/L and ≥125×10 9/L as the boundaries.All patients were followed up until June 30, 2019.Meanwhile, the follow-up data was obtained by consulting medical records or by telephone.SPSS 17.0 software was applied for data analysis. Results:In general clinical features, a different group of hemoglobin (Hb) content, fusion gene AML- ETO and clinical risk stratification were statistically significant in different PLT groups ( χ2=11.270, 12.115 and 12.848, respectively, all P<0.05). However, the differences of other indicators in different groups of PLT were not statistically significant (all P>0.05). There were no statistically significant differences in terms of 3-year disease-free survival(DFS) rate (59.3%, 36.3%, 50.4%) among the 3 groups (all P>0.05). The median total survival(OS)time(40.5 months)and 3-year OS rate(41.0%) of NLG patients were significantly higher than those of VLG(23.1 months, 30.1%)and LG(14.1 months, 18.2%)patients, with statistically significant differences( χ2=7.798 and 6.553, respectively, all P<0.05). The univariate analysis of gender, white blood cell(WBC), Hb, PLT, lactic dehydrogenase(LDH), FLT3-ITD, NPM1, DNMT3A, CEPBA, C-KIT, AML-ETO, molecular genetic prognosis, complete remission(CR), and hemopoietic stem cell transplantation(HSCT) displayed that DNMT3A mutation was an adverse factor that affects patients′ OS ( χ2 =5.834, P<0.05), and the positive factors that influences OS were non-reducing PLT before treatment, and obtaining CR and subsequent HSCT ( χ2=7.798, 79.168, and 31.337, respectively, all P<0.05). Multi-factor analysis revealed that the independent protective factors that affect patients′ OS were the non-reducing PLT before treatment, and obtaining CR and subsequent HSCT( Wald=42.760, 15.918, and 10.183, respectively, all P<0.05). Conclusions:Before treatment, non-reducing PLT is a protective factor for primary childhood AML patients, and the prognosis is satisfying.

Objective To investigate the differences of the working memory tasks' performance between the patients with no neurological syphilis disease and the health controls (HC).Methods 2-back test of N-back task paradigm were applied to measure the performances of working memory.A total of 30 patients with syphilis disease were compared with 35 gender-,age-,years of education-matched healthy persons,then compared the accurate rate and reaction time on the tasks between the two groups.Results Participants with anxiety or depression had to be excluded.The results showed that patients impaired on working memory task.The accurate rate and reaction time of the working memory of the patients was worse than that of the healthy persons ((65.31 ± 8.78) ％ vs (71.00 ±9.64)％ ;(1521.14 ±290.57)ms vs (1296.08 ±253.20)ms respectively) (t=-2.472,P=0.016;t=3.337,P =0.001 respectively).The study indicated the reaction time of the working memory for the patients was negative correlation to the age of final diagnosis (r =-0.362,P =0.049).Conclusion The patients with no neurological syphilis disease show impairment on working memory.This probably because treponema pallidum injures the central nervous system.

Objective To explore the safety and applicability of a temporary protective ileostomy that closes itself in the prevention of anastomotic leakage following anterior resection after chemoradiation for rectal cancer.Methods From Oct 2010 to Oct 2013,54 cases of middle or low rectal carcinoma were admitted.Protective ileostomy was created to prevent anastomotic leakage.Patients were divided into two groups receiving respectively intubation ileostomy (group A,28 cases),and conventional ileostomy (group B,26 cases).Results The mean time for anus to restore defecation was identical in the two groups.The period of protection of the anastomosis,was 21 d (15 ～ 35 d) in group A.The rate of spontaneous closure of the stoma after removal of the tube was 100％.The stoma was reduced after 3 to 6 months in group B and major complication developed in one case in this group.Conclusions Temporary ileostomy prevents anastomotic leakage of anterior resection in patients of rectal carcinoma receiving preoperative neoadjuvant chemoradiotherapy.Intubation ileostomy is effective and safe in prevention of anastomotic leakage saving stoma reduction procedures.