Objective; To evaluate the role of total mesorectal excision in radical resection of rectal carcinoma. Methods:The data of 538 consecutive patients with middle and lower rectal cancer were analyzed retrospectively. These patients were treated with total mesorectal excision between January 1997 and March 2004. Results;All 538 patients had middle or lower rectal cancer, 322 male, and 216 female. No patients died perioperatively and presented presacral hemorrhea. A total of 420 patients were treated by anterior rectal resection; 118 patients had to undergo abdomino - perineal resection. 403 patients were followed - up (12-60 months). The rate of local recurrence was 4.5%. 1 year and 5 - year survival rates after curative resection were 90. 3% and 65. 8% respectively. Conclusion; In our experience, with TME technique, the postoperative mortality and complication would not be increased. The anus - saving rate is increased and the patients'living quality is improved. These findings recommend TME as gold standard procedure for middle and lower rectal cancer.

Three kinds of enzymes,pepsin,trypsin and catalase,were selected to research the effects and mechanisms of ultrasound on protein,taking advantage of the change of their biological activity under sonication as the index.The results indicate that the three kinds of enzymes display different modes and degrees of activity change under sonication.In addition,the effects of ultrasound on the enzymes vary with their concentration,which means that the destruction of ultrasound to enzyme could be reduced by adjusting their concentration.Mannitol,a strong free radical scavenger,and Tween-80,a kind of non-ionic surfactant,could protect the activity of the enzymes during sonication.That implies that free radicals,which are produced through the thermal dissociation of water induced by ultrasound cavitation,and the cavitation bubbles,which could disturb the hydrophobic environment around the enzyme molecules,play important roles during the destruction of sonication to enzymes.However,for different enzyme,different factor play the main role.

Objective To explore the treatment method and clinical effect of LARS artificial ligament in treatment of combined anterior cruciate ligament(ACL) and posterior crueiate ligament (PCL) injuries of the knee under arthroscope. Methods Thirteen cases of ACL and PCL injuries were reconstructed with LARS ligament. The patients were followed up for 12-36 months. The International Knee Documentation Committee (IKDC) and Lysholm knee score scale were used for functional evaluation. In the meantime, KT-1000 was employed to check anterior and posterior laxation of the knee. Results No knee infection or limitation of knee extension occurred. Knee flexion was 105° -125° (average 117°). At termination of follow up, 10 cases (77%) was graded as A and 3 (23%) as B according to IKDC. KT-1000 examination at 25° flexion showed that the difference of anterior laxation was less than 2 mm in 12 cases and 3-5mm in 1. KT-1000 examination at 70°flexion showed that the difference of anterior laxation was less than 2mm in 12 cases and 2-4 mm in 1. The Lysholm score was (63.8±2.9) points (49459 points) before operation and (91.1 ±2.7) points (88-95 points) at follow up, with statistical difference (P ＜0.01). Conclusion Reconstruction of ACL and PCL by using LARS ligament under arthroscope is a kind of minimally invasive, safe and effective method to treat ACL and PCL injuries of the knee, with good short term outcome.

Objective To discuss the mechanism of growth hormone (GH) in infection and its safety. Methods Advances in the application of GH in infection of recent years were reviewed. Results In infectious patients, GH may promote protein synthesis, strengthen the immunity of body, and protect the integrity of intestinal barrier function. But some patients present GH resistance. The safety of GH for infectious patients needs further evaluation. Conclusion GH may play a supplementary role in infection therapy, but further research is needed.

Background Statins has prominent roles in regulating lipids,anti-inflammation,autoxidation and protecting vascular endothelial cells.Sartans can promote cell growth and the expression of cytokines.Since the pleiotropic effects of statins and sartans on a variety of cell types,it is inferred that the two medicines can delay retinal aging.Objective This study was to explore the anti-aging effect of simvastatin and telmisartan on the physiological aging of retina.Methods Sixty-six three-month-old healthy SD rats were selected in this study,and 6 of them served as the youth group and the right eyeballs were immediately enucleated.The other rats were raised until 9-month-old in the same conditions and then randomly divided into the simvastatin group,telmisartan group and the control group with 20 rats for each group.The simvastatin of 5 mg/kg and telmisartan of 8 mg/kg were given by intragastric administration once a day in the simvastatin group and the telmisartan group until 17-month-old,and the equal amount of normal saline was used in the control group in the same way.The number of survival rats was 12 in the simvastatin group,10 in the telmisartan group and 8 in the control group.The right eyes were enucleated after heart perfusion of 4％ paraformaldehyde solution for the preparation of retinal paraffin sections.Retinal thickness was measured by pathological examination,and the expressions of the retinal neuron markers,including Thy-1,protein kinase C-α (PKC-ot),opsin and rhodopsin,were detected by immunofluorescence technique to evaluate the morphology of retinal ganglion cells (RGCs),bipolar cells as well as the thickness of the outer segment of photoreceptors.Results The retinal structure was clear in the rats of the youth group.However,the RGCs arrangement and inner segment (IS) and outer segment (OS) structure were abnormal in the simvastatin group,the telmisartan group and the control group.Compared with the rats of the youth group,the thickness of outer nuclear layer (ONL),outer plexiform layer (OPL),inner nuclear layer (INL),inner plexiform layer (IPL) and the total thickness of the aging rats were decreased,and the IS/OS thickness was increased in the simvastatin group and the telmisartan group (all at P＜ 0.01).Thy-1 stain showed that the number of RGCs was reduced in the simvastatin group,telmisartan group and the control group compared with the youth group,and that in the simvastatin group was increased in comparison with the control group (all at P＜0.01).PKC-αt stain exhibited that the density of bipolar cells was increased but the axon terminal bouton was declined in the simvastatin group,telmisartan group and the control group compared with the youth group,and the axon terminal bouton was declined in the simvastatin group compared with the youth group and the control group (all at P=0.000).Opsin and rhodopsin stains displayed that the OS thickness was increased in the simvastatin group,telmisartan group and the control group compared with the youth group,and that in the telmisartan group was reduced in comparison with the control group (all at P＜0.01).Conclusions As SD rat aging,retinal thickness is gradually attenuated and the number of RGCs is gradually declined.Although the density of bipolar cells seem to be unchanged,their synaptic connections are decreased and the OS is thicken.Simvastatin and telmisartan can delay retinal senescence by protecting retinal neurons against aging and thinning thickened OS.

Objective To investigate the efficacy of bundle care under the supervision of professionals in preven-ting ventilator-associated pneumonia(VAP). Methods Patients who received mechanical ventilation between July 2013 and June 2014 in the intensive care unit(ICU)of a hospital were selected,July-December 2013 was as control group (n= 150),patients received bundle care,but without special supervision;January-June 2014 was as special supervision group (n= 177),patients received bundle care under the supervision of professionals,incidence of VAP,duration of mechanical ventilation,and length of ICU stay were compared between two groups. Results In special supervision group,141 patients received invasive mechanical ventilation,mechanical ventilation day were 1937 days,9 patients developed VAP,incidence of VAP was 4.65‰ ;in control group,127 patients received inva-sive mechanical ventilation,mechanical ventilation day were 1965 days,21 patients developed VAP,incidence of VAP was 10.69‰ ,difference was statistically significant between two groups(χ2= 5.68,P= 0.042). In special su-pervision group,overall compliance rate of bundle management strategies,duration of average invasive mechanical ventilation,and length of ICU stay were 94.92% ,(11.11±2.57)days,and(15.11±2.88)days respectively,in con-trol group were 48.67% ,(14.67±4.35)days,and(19.33±5.81)days respectively,difference was statistically sig-nificant between two groups (all P<0.05). Conclusion Bundle care strategies supervised by professionals can ef-fectively prevent the occurrence of VAP,the implementation of bundle care strategies should be set up according to the clinical practice.

Ultra-wide-field fluorescein angiography (UWFA) is a novel breakthrough in ocular fundus imaging technology, which can capture a single, high-resolution, 200° wide image of the ocular fundus that traditional fluorescein angiography cannot reach. This technology has important impacts on the screening, diagnosis, staging, treatment and follow-up of vascular diseases involving peripheral retina (such as diabetic retinopathy, age-related macular degeneration, retinal vein occlusion, uveitis and so on).

MTH1 enzyme belongs to the family of Nudix hydro-lases, which can prevent the oxidative damage of nucleic acid by cleaning up oxidized purine nucleotides .Close relationships were found between the activity of MTH 1 and neurodegenerative dis-eases, anti-aging et al.In recent years, MTH1 has been regar-ded as a new promising target for cancer treatment , because it plays an essential role in tumor growth , survival , invasion and metastasis.The transcription and translation , structure, catalyt-ic mechanism, detection and application of MTH1 were de-scribed, as well as various MTH1 inhibitors.

Objective Explore the species of pathogenic microorganism and analysis the antibiotic resistance in Emergency department patients in West China Hospital, finding out the evidence for clinical therapy. Methods Select the patients from May 2013 to April 2015 in Emergency department, analyses the species of pathogenic microorganism and the result of drug sensitivity test.Results In the 1 622 cases, there are 1 237 cases of gram-negative bacilli, 324 cases of gram positive coccus, 60 cases of fungus and 1cases of gram-negative coccus, accounted for 76.3%, 19.9%, 3.7%and 0.1%respectively.The top five is E.coli, acinetobacter baumannⅡ, klebsiella pneumoniae, pseudomonas aeruginosa and staphylococcus aureus, accounted for 21.4%, 16.7%, 12.4%, 11.5% and 6.5%; according to the sample species, the detection rate of sputum is highest, accounted for 46.6%, next is blood, urine, secretion; in regard to multiple resistant bacteria, detection rate of ESBL-E.coil, ESBL-KPN , CRAB and MRSA is 62.0% , 26.0%, 80.5% and 26.5%; the detection rate of VREF is 9.4% and does not find Vancomycin resistant enterococcus bacteria. Conclusions The species of pathogenic microorganism in emergency department is rich, especially gram-negative bacilli as E.coli, acinetobacter baumannⅡ, and the drug resistance situation is not optimistic. Emergency department shall communicate with microbiology laboratory timely, pay attention to the situation of the species and the drug resistance result, take rational use of antibiotic according to the results of the analysis of drug resistance.

Objective To investigate the clinical characteristics and related factors of metabolic disorder in acute cerebrevascular disease (ACVD) and to provide clinical basis for intervention of ACVD.Methods The clinical data of 202 healthy individuals (control group) and 621 cases of ACVD (341patients with cerebral infarction and 280 patients with cerebral hemorrhage) was analysed retrospectively.Based on the level of blood pressure,blood glucose and blood fat, 621 cases of ACVD were divided into me tabolism syndrome( MS ) group (hypertension + hyperglycemia + hyperlipidemia),two kinds of risk fatorsgroup (hypertension + hyperglycemia or hypertension + hyperlipidemia or hyperglycemia + hyperlipidemia),one kind of risk factor group (hypertension or hyperglycemia or hyperlipidemia) and no risk fastor group.Results Of the patients with cerebral infarction and cerebral hemorrhage 320 eases(93.8%) and 259 cases (92.5%) had hypertention,163 cases (47.8%) and 101 cases (36.1%) had hyperglycemia, 115 cases (33.7%) and 141 cases (50.4%) had hyperlipidemia, respectively. The blood pressure in one kind of risk factor group, two kinds of risk factors group and MS group was significantly higher than those in control group and no risk factor group,the body mass index (BMI), fasting plasma glucose (FPG),total cholesterol(TG)and low density lipoprotein cholesterol (LDL-C) in two kinds of risk factors group were higher than those in control group and no risk factor group (P <0.05). The age,BMI,blood pressure,FPG,TC,TG,high density lipoprotein cholesterol(HDL-C) and LDL-C had obvious correlation with ACVD. Conclusion ACVD is often combined with various kinds of metabolic disorders risk factors, suggesting that an effective control of metabolic disorders is benefit to intervention of ACVD.