Despite progress in the understanding of perirectal anatomy and subsequent adoption of total mesorectal excision,local recurrence after curative resection for rectal cancer continues to be a significant concern.Local recurrence of rectal cancer is associated with a wide spectrum of clinical symptoms and morbidities,and decreased quality of life.The management of locally recurrent rectal cancer is challenging because of the altered pelvic anatomy,postoperative adhesion and difficulty in obtaining a definite diagnosis before surgery.Surgery is the mainstay treatment for locally recurrent rectal cancer,and the use of radiation and chemotherapeutic agents provides significant improvement in survival rate and quality of life.

Stoma has been used in colorectal surgery for various indications. Stoma type and stoma location are associated with stoma complications and quality of life with a stoma. The question regarding how to avoid stoma complication and improve quality of life should be considered when stoma creation is planned. The benefit of stoma should be balanced with complications brought about by stoma creation.
Enterostomy ; adverse effects ; classification ; Humans ; Postoperative Complications ; Quality of Life

Objective To investigate the effect of electroacupuncture on cervical surface electromyographic signals and explore the mechanism of its action on cervical muscle fatigue in patients with cervical spondylosis.Method All enrolled patients with cervical spondylosis received electroacupuncture treatment. Surface electromyography was performed in the patients before and after the first and one course of electroacupuncture treatment. An evaluation was made using a short-form McGill Pain Questionnaire before and after one course of electroacupuncture treatment. Pre- and post-treatment surface electromyographic RMS values and questionnaire scores were statistically analyzed and compared within the group.Result There were statistically significant differences in cervical erector spinae and upper trapezius RMS values during head lateral flexion and backward extension between before and after the first or one course of treatment (P<0.05). There were statistically significant differences in the questionnaire sub-scores between before and after one course of treatment (P<0.05).Conclusion Electroacupuncture can markedly reduce cervical muscle fatigue in patients with cervical spondylosis. Surface electromyography as a noninvasive and objective evaluation method has a broad application prospect.

Objective To explore the efficacy and safety of tenofovir (TDF)+ lamivudine (3TC)+ efavirenz (EFV)combina-tion therapy in the treatment of HBV/HIV coinfection and provide evidence for effective management of HBV/HIV coinfec-tion.Methods All the AIDS/HIV patients treated in our hospital from February 2011 to October 2011 were screened for eligi-bility in this analysis.Twenty eligible patients with HBV/HIV coinfection were treated with the TDF/3TC/EFV triplet regi-men.The efficacy and safety of the combination therapy were evaluated.Results Of the 15 patients who had completed study period of 48 weeks,all had conversion of HBV DNA to negative,2 had HBeAg seroconversion.The liver function tests were normal.HIV-RNA was below the limit of detection in 15 cases.CD4+ increased by 139.72±3.36/μL on average.The creati-nine and lactate levels were within normal limits.No adverse events were reported.Conclusions The TDF/3TC/EFV triplet regimen is safe and effective for treatment of HBV/HIV coinfection.It is appropriate to recommend this regimen as a standard therapy for HBV/HIV coinfection.

Objective To comparison of clinical efficacy between mini-invasive transforminal lumbar interbody fusion(mis-TLIF) assisted by Quadrant system and open posterior lumbar interbody fusion (PLIF)treatment for lumber spondylolisthesis,to find a better treatment for lumbar spondylolisthesis.Methods A total of 65 cases who were under lumber spondylolisthesis were retrospectively selected from our hospital,26 cases in mini-invasive transforminal lumbar interbody fusion assisted by Quadrant system (mis-TLIF group).39 cases in open posterior lumbar interbody fusion(PLIF group).Record the incision length,intraoperative blood loss,opertive time,bed time,hospital time,pre-and post-operative visual analogue scale(VAS) and Oswestry disability index(ODI) score were recorded respectively.After surgery,the imaging(X-Ray) evalute the vertebral fusion status.Results There were no significant difference between mis-TLIF group and PLIF group in BMI [(22.77 ± 4.38) kg/m2 and (21.28 ± 5.24) kg/m2],preoperative VAS score [(6.46 ± 1.67) and (6.59 ± 1.56)],preoperative ODI score [(58.70 ± 7.19) ％ and (60.10 ± 9.56) ％] (all P ＞ 0.05).There were significant difference between two groups in incision length [(6.10 ± 0.95) cm and (11.12 ± 2.02) cm],intraoperative blood loss [(247.31 ± 36.72) ml and (340.51 ± 64.32) ml],opertive time[(179.96 ± 17.54) min and(151.85 ± 16.06) min],bed time[(3.62 ± 1.44) d and (4.98 ± 1.74) d],hospital time [(9.38 ± 2.60) d and (11.95 ± 3.61) d] (all P ＜ 0.05).Postoperatively VAS score was assesssd at 1 month [(3.15 ± 1.08]),3months [(1.58 ± 0.81)],6months [(1.08 ± 0.74)] and ODI score was(30.77 ± 6.45) ％,(25.54 ± 6.33) ％,(20.23 ± 7.05) ％,respectively in mis-TLIF group were lower than those of PLIF group (P ＜ 0.05).There were no significant difference between two groups in the fusion rate in 3 months,6 months after operation.Conclusion Mis-TLIF had a lot of advantages relative to PLIF in the treatment of lumber spondylolisthesis,be like less trauma,less bleeding,less hospital time,quick rehabilitation and good curative effect,provide a new minimally invasive method for lumber spondylolisthesis patient.

Objective To discuss the value of holmium laser lithotripsy combined with choledochoscopy in the treatment of complicated common bile duct stones.Methods Under choledochoscopy,200 ?m fibre holmium laser lithotripsy of common bile duct stones was performed.The settings on the laser were 1.0 J and 10 Hz.The choledochoscope was used to access the common bile duct stones.The stones were fragmented and then extracted with irrigation or by using a basket. Results The stones were successfully removed in all the 17 cases.The duration of operation was 10~50 min(mean,20 min).Out of the 17 cases,there were 8 cases of primary closure of the common bile duct,6 cases of T-tube drainage, and 3 cases of stone removal via drainage passage.No bile duct bleeding or biliary leakage occurred after operation.Follow-up was conducted in 16 cases for 6~15 months(mean,10 months).B-ultrasonography or magnetic resonance cholangiopancreatography found no recurrent or residual stones,or bile duct stricture.Conclusions Holmium laser lithotripsy combined with choledochoscopy in the treatment of complicated common bile duct stones has advantages of minimal invasion,rapid recovery,satisfactory lithotripsy effects,simplicity of performance,and high reliability.

OBJECTIVE:To provide reference for improving the national assessment programs of sampling and testing policy. METHODS:Questionnaire was designed to investigate the drug manufacturers’attitude and suggestions to the national assessment programs of sampling and testing policy;SPSS 18.0 software was adopted to analyze the data;a reliability analysis was conducted for the 17 variables in the table;and a principal component analysis was conducted for the topics with strong correlation. RE-SULTS:A total of 340 questionnaires were sent out,314 were effectively received with the effective rate of 92%. the total internal consistency reliability coefficient Alpha was 0.92;the awareness coefficient of enterprise on the evaluation of sampling and testing was 9.78;4.24 enterprises were relatively agree the evaluation of sampling and testing;the attitude coefficient of enterprise on the improvement of evaluation of sampling and testing was 13.39;and the average score of enterprise on the overall satisfaction scoring was 8.73. CONCLUSIONS:The drug enterprises show high overall recognition for the national assessment programs of sampling and testing policy,and willing to cooperate with the development,and hoping the policy can be improved.

Objective To study the expression changes of?-catenin in the hair follicle before and after GasderminA3 gene mutation.Methods Using SP immunohistochemical staining,RT-PCR,Western blotting to detect the expression of?-catenin in the hair follicle in GSDMa3 mutant and C57BL/6(B6) mice on postnatal 11(anagen) ,16(early catagen) ,18(late catagen) and 24 d(telogen) respectively.Results The expression of?-catenin is gradually weakened from 11 d to 24 d in GSDMa3 mutation mice and B6 mice,but stronger expression was found in GSDMa3 mutation mice than in the B6 mice at different time points.In anagen,?-catenin was expressed in the inner and outer root sheath and hair matrix cells,with stronger expression in GSDMa3 mutant mice than in B6 mice.In catagen,?-catenin was mainly expressed in the outer root sheath and hair matrix cells,with more stronger expression in GSDMa3 mutant mice than in B6 mice.In telogen,?-catenin was expressed in the outer root sheath cells in the mutant mice while little in the hair follicle in B6 mice.Conclusion GSDMa3 gene affects the hair follicle growth and development,probably through regulating the expression of?-catenin.

Fused teeth is defined as the union of enamel and dentin of two or more teeth germs,yielding a single tooth during tooth develop-ment.Their treatment is complex and usually need multidisciplinary approaches.This report presents a case of fused teeth treated by he-misection and discusses the clinical features and treatment options.

[Abstrct] Objective The deformity of severe varus knee (varus angulation > 15°) can be treated by many ways in primary total knee arthroplasty , but the efficacy and cost are different. The topic of this study provides a new surgery: autograft (wedge grafts) implant and substitute medial tibial bone defects. Methods From Jan. 2006 to Jan. 2014 , a retrospective study was conducted in the First Affiliated Hospital of BaoTou Mendical College. Out of 687 patients, 721 primary knees were operated. Bone defects in proximal tibia (varus angulation >15° ) were encounted in 16 patients in 21 knees in the pattern of non-inclusive slope bone defects in the mean varus degree of 27°. Their IBM was 31 kg/m2. The average age of patients was (63 ± 5) years. The score of clinical knee society score (KSS) before operation was 18 on average. Among of them, the pain score were 12 points, the average range of motion (ROM) were 12 points. the average funtional score were 20 points. During operation,the slope bone defect of the medial tibial plateau was tailored into wedge-shaped ladder bone defect by osteotomy,and then the defect was filled with the resected tibial plateau autograft in which the thickness and shape were matched completely. The high-intensity cortical part of the autograft was placed in the rim to sustain the tibial prosthesis. Three months after operation ,patients started to walk without the help of crutch. Results The average followup period was 5.3 y , We observed that an average postoperative scores of clinical KSS from 42 points to 88 points with the score of functional KSS from 57 points to 92 points. Fusion was observed by trabeculae crossing from the graft to the tibial metaphysis on plain films at least 6 mouths without collapse, stress fracture, untight and bone ununion. Confirmation of vascularization of the graft was observed in bone scans of nuclide. showing increased uptake in the operated area. Inflammatory makers were normal. Conclusion Autograft (wedge grafts) reconstruction of medial tibial bone defects, is of high rate of healing in implant bones, good restoration of the function and low cost.