New technologies and ideas are constantly emerging recently. With the arrival of the era of minimally invasive surgery, most of the colorectal cancer surgeries can be conducted through minimally invasive techniques. In this study, we discuss the status, characteristics, controversy, and consensus of minimally invasive techniques in colorectal cancer surgery.

Myasthenia gravis is autoimmune diseases which mediated with acetylcholine receptor antibody.Based on the studies in rencent years,treatment of MG has made great progress.Thisreview will discuss several aspects,such as immune tolerance induced by dendritic cells,blocking monoclonal antibodies,hematopoietic stem cell transplantion,and provide new ideas and methods for the treatment of myasthenia gravis.

Objective To summarize the main nursing point and experience of allogeneic small bowel transplantation.Methods One case underwent allogeneic small bowel transplantation in our hospital on the first of December 2010,the nursing measures were summarized.Results The patient passed the operation well-off,and survived the infection phase and repulsion phase in the transplantation ward.Conclusions Valid preoperative evaluation,taking active measures to prevent intraoperative hypothermia and infection,using self-made vacuum pads to prevent pressure sores during operation,are the guarantees for successful operation.

Objective To analyze the clinical effectiveness,safety and significance of treatment with external circular fixator,through the relationship of inducible nitric oxide synthase (iNOS) and bone regeneration to further explore the mechanism of the molecular biology of bone lengthening at the same time.Methods Collected bone defect after tibial shaft fractures secondary infection who were treated with external circular fixator as study group (28 cases),all the cases fixed by external circular fixator,20 healthy volunteers as control group.Study group in different time point measured the levels of serum iNOS content,were compared with the control group.Results All patients were scheduled to reach the extremity lengthening and the bone defect were repaired and healed in study group.The bacterial culture results showed that 18 cases (64.29％,18/28) of resistant Staphylococcus aureus,5 cases (17.86％,5/28) of Hemolytic streptocaccus,2 cases (7.14％,2/28) ofP.aeruginosa,one case (3.57％,1/28) of drug-resistant Enterobacter cloacae,one case(3.57％,1/28) of Staphylococcus epidermidis,one case(3.57％,1/28) of Onion-like aeromonas,the proportion of the former two was significantly higher than other bacteria (P ＜ 0.05).The levels of serum iNOS content 1 d after surgery in study group were increased,compared with control group,difference was no significant (P ＞ 0.05).The levels of serum iNOS content 14 d after surgery,stoped extend,1 d stoped extend,3 d stoped extend in study group were significantly higher than those in control group [(118.8 ± 6.6) U/L vs.(86.4 ± 5.4) U/L,(136.2 ± 8.4) U/L vs.(88.2 ± 3.6) U/L,(132.6 ± 9.0) U/L vs.(87.6 ± 4.8) U/L,(103.8 ± 5.4) U/L vs.(86.4 ± 4.2) U/L] (P ＜ 0.05),there was no significant difference between two groups in other times (P ＞ 0.05).Conclusions External circular fixator for the repair and reconstruction effects in patients with bone defect can achieve the desired therapeutic goal,the higher expression of iNOS may be one of the molecular biological mechanisms of bone lengthening.

Objective To investigate the expression of uPAR and VEGF-C in hepatocellular carcinoma (HCC) and its effect on the biological behavior of HCC. Methods The expression of uPAR and VEGF-C in liver tissue specimen of 33 patients with HCC was detected by immunohistochemical staining. Results The positive expression of uPAR and VEGF-C in HCC tissues was located in cytoplasma of cancer cells. The positive rates of uPAR and VEGF-C were 69.7 %(23/33) and 78.8 %(26/33) respectively in 33 cases of HCC. The expression rates of uPAR and VEGF-C were significantly higher in HCC with metastasis than in HCC without metastasis(P<0.05). But there were not significant correlation between the expression of uPAR or VEGF-C and tumor size, tumor grade, AFP level, hepatic cirrhosis. There was a close correlation between uPAR and VEGF-C in HCC(r=0.676, P<0.01). Conclusion The expression of uPAR and VEGF-C is correlated with metastasis, uPAR and VEGF-C may be signs of aggressive phenotype for evaluating treatment and prognosis of HCC. Examination of these two proteins may be helpful to .judge biological behavior of HCC.

Objective To investigate the role of survivin gene in the pathogenesis of endometriosis (EMs). Methods The expressions of survivin in endometriosis and normal endometrium tissue were determined ; the effects of GnRHa and COX-2 on the expression of survivin mRNA in endometriosis and normal endometrium in vitro and the effects of GnRHa and COX-2 on the apoptosis index in the cultured ectopie endometrial cells were investigated. Re-sults ①The expression of survivin mRNA was higher in patients with endometriosis than that of healthy controls (P <0.01) ,with no cyclical variation. ②GnBHa exerted a dose-dependent suppression of survivin mRNA expres-sion in cultured ectopic endometrioma cells as well as COX-2. The significant suppression was observed at the 100μg/L concentration of GnRHa and at the 40 μmol/L concentration of COX-2. No cooperation was found between them (P > 0.05). Conclusion ①The up-regulation of survivin mRNA expression may reduce the sensitivity of en-dometriotic cells to apeptosis. Elevated expression of survivin mRNA in ectopic endometrium may have important im-plications for the survival and proliferation of the ectopic endometrial tissue.②Both GnRHa and COX-2 can promote apoptosis by inhibiting survivin mRNA expression in ectopic endometrioma cells in vitro.

BACKGROUND:With elevated medical levels, limb salvage surgery for limb malignant tumor is valuable day by day. At present, the limb salvage surgery has substituted amputation and becomes mainstream and development direction of present surgical treatment of limb tumors. However, so far, there are no unified surgical indications for proximal femur tumor, which are controversial. OBJECTIVE:To investigate the efficacy of artificial total hip arthroplasty combined with extended resection of tumor sections for proximal femoral bone tumors. METHODS:Patients with proximal femoral bone tumors in the Second Xiangya Hospital of Central South University were selected and divided into control group and observation group, with 30 patients in each group. According to the disease, lesion curettage, aneurysm wal inactivation, autologous and (or) al ogeneic bone, mixed bone graft and bone graft fixation were selected to treat the control group. The observation group patients received extended resection of tumor sections and total hip arthroplasty. The operative time, intraoperative blood loss, hospital stay and joint function of two groups were compared. 2 years later, patients were revisited. Metastasis and recurrence rate, death rate and quality of life of two groups were compared. RESULTS AND CONCLUSION:There was no significant difference in intraoperative blood loss and surgery time between the two groups (P>0.05). However, hospital stay of patients in the observation group was shorter than the control group. The excellent and good rate of recovery of joint function (83%) was higher in the observation group than in the control group (53%). The metastasis and recurrence rate within 2 years after surgery (7%) and death rate (3%) were lower in the observation group than in the control group (30%, 23%). Various indicators of quality of life of patients in the observation group were significantly better than the control group (P<0.05). These results confirmed that artificial total hip arthroplasty in the treatment of proximal femur tumors is safe and effective.

Purpose To investigate the alterations of homotopic functional connectivity and interhemispheric structural connectivity in patients with unilateral temporal lobe epilepsy (unilateral TLE).Materials and Methods Resting-state functional MR imaging data were acquired from patients in the first affliated hospital of Guang Zhou Medical University who were enrolled from Oct.2013 to Oct.2015 with unilateral temporal lobe epilepsy (n=43) [21 left TLE(LTLE) and 22 right TLE(RTLE)] and normal controls (NC) (n=24).We mainly concerned about the functional connectivity between any pair of symmetric interhemispheric voxels which were measured by voxel-mirrored homotopic connectivity (VMHC).Structural magnetic resonance images were acquired in 10 LTLE patients,16 RTLE patients and 20 NCs.Homotopic regions showing abnormal functional connectivity in patients were adopted as regions of interest for DTI.The FA values were compared between groups.Two-sample t test were used.Results Compared with NC group,the LTLE patients showed increased interhemispheric functional connectivity among the bilateral angular gyri,occipital gyri and superior parietal gyri,and decreased functional connectivity between the bilateral supplementary motor areas,middle temporal gyri,medial frontal gyri and inferior parietal lobules.Compared with control subjects,RTLE patients exhibited increased interhemispheric functional connectivity among bilateral inferior occipital gyri,parahippocampa gyri,cerebellum,as well as decreased functional connectivity among the bilateral middle temporal gyri,precentral gyri and inferi or frontalgyri.Statistical results indicated that the FA value of the commissural fiber bundles connecting the bilateral hippocampal gyri was smaller in RTLE patients than NC patients (t=10.55,P＜0.01).The FA value of the association fibers connecting the bilateral hippocampal gyrus had no significant difference between the LTLE group and NC group.Conclusion The increase or decrease of VMHC value in some brain regions in TLE suggested that there were changes in the functional synchronization and coordination in the two hemispheres in patients with unilateral TLE.In the RTLE patients,some brain regions which had abnormal interhemispheric functional connectivity also had structural damage.

Objective To investigate the pathogen and inspection methods of the middle-aged women with constipation and evaluate the accuracy and clinical application of imaging to constipation.Methods First colonic transit test were used to 98 cases of middle-aged women who were diagnosed constipation by doctors,then air-barium double contrast examination were applied.Defecation radiography or simulation rectum defecography were used to those who were diagnosed as outlet obstruction.According to the measure target and diagnostic criteria of professor LU,the results were studied.Results 6 cases were abnormal within 8 cases who were inspected by barium enema.14cases were abnormal within 16 cases who were inspected by defecation radiography.Colonic transit test were used to 74 cases and only 6 cases were normal.16 cases were true slow transmission and 20 cases were false slow transmission.52 cases were outlet obstruction.20 volunteers were inspected by suspension barium sulfate and simulation rectum defecography.Conclusions Air-bariun double contrast examination could discover the organic disease and abnormal of rectum.colonic transit test,defecation radiography and simulation rectum defecography were simply and perfect methods to discover the pathogen of constipation.

Objective To investigate whether HBx alone is sufficient to directly transform the nontransformed immortalized human liver cell line QSG7701 and induce hepatocellular carcinoma in vivo,and to explore preliminarily the pathogenic mechanism of transplantation tumor in nude mice.Methods The pCMVX/QSG7701 cells were vaccinated into subcutaneous tissue of nude mice.The pRcCMV2/QSG7701 and QSG7701 Cells were used as control.At the fifth weeks after vaccination,the nude mice were killed to observe whether a tumor was formed.The activity state and food intake of the nude mice was recorded.The texture,volume,and metastasis of transplantation tumor were observed grossly.The transplantation tumor was observed microscopically on the hematoxylin and eosin (HE) staining section.Immunohistochemical surfactant protein (SP) method was used to analyze the protein expression of mutant p53 and C-Myc genes.Results The transplantation tumor was occurred in all of the six nude mice vaccinated with pCMVX/QSG7701 cells at the second week after vaccination.No metastatic tumor was found in other organs.Transplanted tumor was not formed in all of the negative control groups.HE staining analysis confirmed that the character of transplanted tumor was hepatocellular carcinoma.p53 and C-Myc proteins were expressed in pCMVX/QSG7701,pRcCMV2/QSG7701,and QSG7701 cells,and their expression levels in the pCMVX/QSG7701 cells were significantly higher than those in the pRcCMV2/QSG7701 and QSG7701 cells,respectively(P ＜0.01).Conclusions HBx alone is sufficient to directly transform the non-transformed immortalized human liver cell line QSG7701 and induce hepatocellular carcinoma in vivo through up-regulating the expression of mutant p53 and C-Myc genes.