OBJECTIVE:To observe therapeutic efficacy and safety of Xiaoer jiegan granules with Ribavirin in the treatment of acute upper respiratory tract infection. METHODS:98 patients with upper respiratory tract infection were randomly divided into obser-vation group and control group with 49 cases in each group. Control group was given Ribavirin injection for routine upper respiratory tract antiviral therapy,10-15 mg/kg,added into 5% Glucose injection 250 ml,ivgtt,qd. Observation group was given Xiaoer jiegan granules,1g/time for 1-3 year-old children,2g/time for 4-6 year-old children and 3 g/time for 7-9 year-old,tid. A treatment course of 2 groups lasted for 5 days,both received 2 courses of treatment. Clinical efficacy,cough and other symptoms score,ADR were ob-served in 2 groups. RESULTS:The effective rate of observation group (97.96%) was higher than that of control group (87.76%), with statistical significance(P<0.05). Before treatment,there was no significant difference in the scores of fever and cough and other symptoms between 2 groups,with statistical significance(P>0.05);after treatment, the scores of fever and cough and other symp-toms in observation group were lower than in control group,with statistical significance(P<0.05). The incidence of ADR in the ob-servation group(6.12%)was significantly lower than in control group(22.45%),with statistical significance(P<0.05). CONCLU-SIONS:Xiaoer jiegan granule with Ribavirin is effective in the treatment of acute upper respiratory tract virus infection,and can im-prove fever,cough and other clinical symptoms,so as to promote better conditions and reduce the occurrence of ADR.

Objective To explore the expression of ininor histocompatibility antigen 13 (HM1 3) in gastric carcinoma and the relationship with clinicopathological parameters and prognosis.Methods The expression of HM 13 was detected by immunohistochemistry in a total of 90 pairs of paraffin-embedded gastric cancer tissue specimens and corresponding paraneoplastic tissues.The correlation between clinicopathological parameters and the expression of HM13 in gastric carcinoma were also analyzed.Downstream gene heme oxygenase-1 (HO-1) expression was detected by qRT-PCR after HM13 gene was interfered.Results High expression of HM13 protein was observed in 47％ gastric carcinoma compared with that in 61％ corresponding paraneoplastic tissues (x2 =3.78,P =0.052).HM13 expression has positive correlation with pathological TNM stage (x2 =5.022,P =0.025) and distant metastasis (P =0.033),but not with age (x2 =0.832,P =0.362),gender (x2 =0.779,P =0.378),tumor size (x2 =0.804,P =0.370),tumor differentiation (x2 =0.430,P =0.512),gross types (x2 =2.069,P =0.150),tumor stromal invasion (x2 =0.167,P =0.683) and lymph node status (x2 =0.396,P =0.529).The patients with low HM13 expression had worse overall survival [(OS):(30 ± 5) months vs.(47 ± 5) months,x2 =6.456,P =0.011] and progress free survival [(PFS):(29 ± 5) months vs.(46 ± 5) months,x2 =6.742,P =0.009].Expression of HO-1 was up-regulated after HM13 gene was interfered (0.532±0.013 vs.0.395±0.011,t=13.93,P＜0.05).Conclusion The low expression of HM13 is associated closely with advanced stage and distant metastases of gastric carcinoma.

Objective To detect the expressions of enhancer of zeste homology 2 (EZH2) and signal transducer and activator of transcription 3 (STAT3) in gastric cancer tissues,and analyze the relationship between their expressions and clinicopathological factors and prognosis of patients.Methods The clinical data of 67 patients with gastric cancer who were admitted to the People's Hospital of Peking University from May 1999 to April 2000 were retrospectively analyzed.Gastric cancer tissues and adjacent normal tissues were harvested and fixed in 4％ formaldehyde,and then to make the tissue chips.The protein expressions of EZH2 and STAT3 were detected by immunohistochemical staining,and the relationship between the expressions of EZH2 and STAT3 and the prognosis of patients was analyzed.The correlation between the protein expressions of EZH2 and STAT3 in the gastric and colorectal tissues and the clinicopathological parameters was analyzed using the paired chi-square test.The survival curve was drawn by Kaplan-Meier method,and the survival rate was analyzed by using the Logrank test.The relationship between the clinicopathological factors and the prognosis of patients was analyzed using the COX proportional hazard model.Results The positive protein expression rates of EZH2 and STAT3 in the gastric cancer tissues were 73.1％ (49/67) and 67.2％ (45/67),which were significantly higher than 32.8％ (22/67) and 37.3％ (25/67) in the adjacent normal tissues (x2=21.839,11.964,P ＜0.05).The protein expression of STAT3 was correlated with the age,TNM staging,lymph node metastatic status (x2=5.475,9.998,5.475,P ＜ 0.05).The protein expression of EZH2 was correlated with TNM staging and lymph node metastatic status (x2=11.573,5.902,P ＜ 0.05).The co-expression rate of EZH2 and STAT3 proteins was 73.1％ (49/67),EZH2 and STAT3 had the common expression trend (r =0.397,P ＜ 0.05).The co-expression rate of EZH2 and STAT3 was increased as the increase of TNM stages,and the co-expression of EZH2 and STAT3 in the gastric cancer tissue was correlated with the TNM stages (x2 =6.997,P ＜ 0.05).The 5-year survival rate of patients with low protein expression of EZH2 was significantly higher than those with high protein expression of EZH2 (x2=7.386,P ＜ 0.05).The 5-year survival rate of patients with low proteins expression of STAT3 was significantly higher than those with high proteins expression of STAT3 (x2=12.253,P ＜ 0.05).The 5-year survival rate of patients with low co-expression of EZH2 and STAT3 protein was significantly higher than those with high co-expression of EZH2 and STAT3 proteins (x2 =8.765,P ＜ 0.05).The results of univariate analysis showed that age,TNM staging,EZH2 and STAT3 expression,lymph node metastasis and distal metastasis were the factors influencing the survival of patients with gastric cancer (RR =2.136,3.452,3.179,8.341,11.773,6.873,P ＜0.05).The results of multivariate analysis showed that TNM staging and STAT3 expression were independent factors influencing the prognosis of patients with gastric cancer (RR =2.453,7.535,P ＜ 0.05).Conclusions There is significant correlation between EZH2 and STAT3 protein expressions in gastric cancer tissues,and co-expression of EZH2 and STAT3 is associated with the TNM staging and the prognosis of the patients with gastric cancer.

Objective To explore the expression of N-myc downstream regulated gene 1 (NDRG1) in gastric carcinoma and the relationship with clinicopathological parameters and prognosis. Methods The expression of NDRGI was detected by immunohisto chemistry in formalin-fixed and paraffin-embedded sections with a total of 220 specimens including 110 gastric carcinoma and 110 corresponding paraneoplastic tissue. The correlation between clinicopathological parameters and the expression of NDRG1 in gastric carcinoma were also analyzed. Results Low expression of NDRG1 was detected in most gastric carcinoma sections. Among the gastric cancer tissues, NDRG1 protein expression was significantly lower in tumors with more advanced pathological stage, local tumor invasion and lymphatic metastases. There was no significant difference in sex, age, tumor differentiation and gross types of the tumor. The 1-, 3- and 5 year survival and disease free survival in patients with low NDRG1 protein expression was 84.2%, 53.9%, 21.1%, and 60.5%, 31.6%, 19.7%, respectively, which was signifivantly poorer when compared with patients with high NDRG1 protein expression. Conclusion The expression of NDRG1 is low in the majority of patients with gastric carcinoma, which was in a close relationship with advanced stage, local invasion and lymphatic metastases of gastric carcinoma. NDRG1 may be a candidate metastasis suppressor gene.

Objective To investigate microRNA-217 expression and its significance in colorectal cancer.Methods MiR-217 expression was detected in 30 cases of colorectal cancer tissues and corresponding adjacent normal colorectal tissues by qRT-PCR.The clinicopathologic correlations of miR-217 expression were performed using Fisher's exact test.Kaplan-Meier method was used to evaluate the overall survival of patients.Results MiR-217 was significantly lower in colorectal cancer tissues than in normal colorectal tissues (P ＜ 0.01).Moreover,the decreased miR-217 level was significantly associated with tumor size and TNM stage,as well as lymph node and distant metastasis.Meanwhile,patients of colorectal cancer with low levels of miR-217 expression had a significantly shorter median survival (x2 =4.584,P ＜ 0.05) than those with high levels of miR-217 expression.Conclusions Downregulated miR-217 in colorectal cancer tissues correlates to poor prognosis in postoperative colorectal cancer patients.

Objective To explore the clinical outcomes of laparoscopic appendectomy in acute and chronic appendicitis,and sum up the surgical experiences of lapaproscopic appendectomy.Method In this study 129 cases of appendicitis at the Department of Gastroentrological Surgery,Peking University People's Hosptial were collected retrospectively from June 2008 to December 2009.The clinical results of laparoscopic and open procedures for acute appendicitis and the outcomes of laparoscopic operation for acute and chronic appendicitis were compared.Results For acute appendicitis,the length of hospitalization [(4.8 ± 2.6) d vs.(7.0 ± 1.3) d,t =0.679,P =0.006] was significantly shorter in laparoscopic group than that in open surgery group.In addition,the mean length of operation time [(77 ± 33) min vs.(55 ± 23) min,t =3.431,P ＜0.01] were longer,postoperative first passing flatus [(2.3 ± 1.2) d vs.(1.4 ±0.9) d,t =4.665,P ＜0.01] and oral intake [(2.3 ± 1.4) d vs.(1.2 ±0.6) d,t =4.517,P＜0.01] were later for acute appendicitis patients than for chronic appendicitis in laparoscopic group.Conclusions Laparoscopic appendectomy for acute appendicitis is a safe and effective procedure,though it might cause more postoperative complications such as intra-abdominal abscess and small intestinal obstruction in patients with acute appendicitis.

Objective To investigate the applied perineal anatomy of the pudendal nerve of female and its direction to perineal operation.Methods The gross anatomy were done on 20 female cadaver(ensuring the pelvic,the hip and the perineum were intact).In each cadaver,the dissection proceeded from intrapelvic,the pudendal canal(Alcock'canal) and the ischiorectal fossa.The composition,track,abut,ramus and domination area of female pudendal nerve were examined.Results The gross anatomy showed that the pudendal nerve was composed of the ventro-branches of sacral nerve 2~4(S_2~S_4).The pudendal nerve sends off anal branch at level of the ischial spine.And the trunk courses in the internal pudendal canal forwardly and inwardly send off the perineal nerves and dorsal nerve of clitoris.The perineal nerves sends off branches to back lunar labium,muscle and urethra.The dorsal nerve of clitoris sends off the nerve to skin of clitoris,and some to the urethra simultaneously.The pudendal nerve has different abut in different anatomical position.Conclusions The perineal anatomy of the pudendal nerve has the meaningful direction to the perineal operations.

Objective To compare the therapeutic efficiency of laparoscopic and open radical colorectal surgery in the treatment of colorectal carcinoma. Methods Clinical data of 77 cases undergoing laparoscopic colorectal surgery from September 2004 to October 2007 were compared with 90 patients treated by open surgery. Results Mean operating time was longer in the laparoseopic group than that in the open group [248 minutes vs. 225 minutes (t = -2. 11 ,P =0. 036)], blood loss was less in laparoscopic group [210 ml vs. 315 ml (t = 2. 82, P = 0. 005)]. Laparoscopic surgery was associated with lower rate of analgesia use [48% vs. 80% (x2 = 18. 69 ,P < 0. 01)], earlier recovery of bowel function [2. 9 days vs. 4. 3 days(t =5.59,P <0. 01)]and shorter hospital stay [12. 5 days vs. 15.5 days (t =2. 32,P=0. 039)]compared with open surgery. The number of removed lymph nodes [14. 2 vs. 15.3 (t = 1.04, P = 0. 3)]and length of reseeted bowel [18. 9 cm vs. 20. 0 cm, (t = 0. 88,P = 0. 383)]were not different between the two groups. The mean follow-up time of the two groups were 28 months, local recurrence rate, metachronous metastases rate and 3-year cumulative survival rate were not statistically different between the two groups. Conclusion Laparoscopic surgery is as effective as conventional open surgery in the treatment of colorectal carcinoma.

ObjectiveTo investigate the effectiveness and feasibility of intraoperaive recurrent laryngeal nerve(RLN) monitoring via lateral cricoarytenoid muscle(LCA) compound muscle action potential (CMAP) monitoring by bipolar electrode implanting. MethodsSeventy-four cases were evenly divided into nerve monitoring group and non-monitoring group,NIM-Response 2.0 was applied into monitoring group for intraoperative nerve monitoring.A bipolar electrode was inserted into LCA to record CMAP,stimulating electrode intermittently stimulated exposed or unexposed recurrent laryngeal nerve to monitor the RLN function during cervical operation under the block anaesthesia of cervical plexus. ResultsThere were no statistically significant differences (P ＞ 0.05 ) in postoperative hospitalization days (5.14 ± 1.44 days,5.05 ± 1.31 days),operation time ( 125.54 ±42.23 min,107.30 ± 39.36 min) between monitoring group and the control group.Thirty-two RLNs were mapped their anatomical course with the NIM-Response 2.0 assistance before exposure,and 25 RLNs were anatomically exposed.The stimulating threshold between unexposed RLN (2.23 ± 0.57 mA) and exposed RLN ( 0.44 ± 0.20 mA) were statistically different ( P ＜ 0.01 ),but the evoked EMG amplitude(307.98 ± 253.47 μV,234.36 ± 142.18 μV) were not statistically different (P ＞ 0.05 ).With the NIM-Response 2.0 assistance the course of the unexposed RLNs detected were consistent to the course of the RLNs when exposed completely.ConclusionsIt is a effective and feasible method to monitor the RLN function by recording the CMAP of lateral cricoarytenoid muscle(LCA) via bipolar electrode implanted into LCA under block anaesthesia of the cervical plexus.

OBJECTIVETo explore the feasibility and safety of transperineal single-port laparoscopy assisted exralevator abdominoperineal excision(TPSP-ELAPE).

METHODSThree cases (2 males and 1 female) who underwent TPSP-ELAPE at lithotomy position in the Peking University People's Hospital from January to February 2016 were analyzed retrospectively. The mean age was(55.3±7.2) years. Mean body mass index (BMI) was (23.0±1.3) kg/m(2). Mean distance between tumor and anal verge was (1.8±0.3) cm. Abdominal procedure was done firstly and then perineal procedure under lithotomy position. Abdominal procedure was performed by routine laparoscopy with 5 trocars. TPSP-ELAPE procedure was performed in perineal procedure. The perineal defect was closed by purse string, followed by spindle incision around the anus. Perianal skin and subcutaneous tissue was dissected until the junction between extra anal sphincter and levator ani muscle under direct vision. Perineal skin was sutured with double purse string by 2-0 prolene, and single port canal was placed inside in order to close perineal defect. The pneumoperitoneal pressure was set to 10 mmHg and laparoscopy and instrument was placed through the single-port canal. Space between isochioanal fossa and levator ani muscle was exposed by the contraction of laparoscopic clam. Lateral and posterior side was mobilized firstly. The anterior was dissected under the help of vaginal examination and contraction by abdominal group. The levator ani muscle was divided near the initial site, and negative resection margin was confirmed in the operation. Specimen was exteriorized through the perineum.

RESULTSThe mean intraoperative blood loss of three cases was (123.3±25.2) ml. The total operative time was (296.7±25.1) minutes. The time used by the perineal group was (196.7±20.8) minutes. The volume of drainage was (39.0±10.1) ml at the third day after operation. The time to first stoma output was (2.3±0.6) days. The perineal drainage removal time was (7.7±0.6) days. The circumferential resection margins were negative in all specimens, and there were no perioperative complications.

CONCLUSIONTPSP-ELAPE is feasible and safe, which could avoid turning over the patient and facilitate anesthesia. It follows the anatomic plane of open ELAPE procedure with minimally invasive advantage.

Anal Canal ; Blood Loss, Surgical ; Digestive System Surgical Procedures ; methods ; Feasibility Studies ; Female ; Humans ; Laparoscopy ; methods ; Male ; Middle Aged ; Operative Time ; Pelvic Floor ; Perineum ; surgery ; Rectal Neoplasms ; surgery ; Retrospective Studies ; Surgical Stomas