Nineteen patients with low rectal cancer underwent laparoscopy-assisted anterior resection with prolapsing technique for sphincter preservation.The clinical data were retrospectively reviewed.Fecal continence was preserved successfully in all patients.There was no perioperative mortality,only two cases with anastomotic leak and one case with local recurrences.Laparoscopy-assisted anterior resection with a prolapsing technique for low rectal cancer is safe procedure and can be an alternative sphincter-preserving operation.

ObjectiveTo investigate the amount of bacteria and the expression of amylase and lipases in the drainage fluid in patients with intestinal fistulas with time courses.MethodsThe samples were collected from 16 patients with high intestinal fistulas from July 1998 to January 2008.The amounts of bacteria from the drainage fluid were measured 0,2 and 4 hours after taking out from the patients.At the respective time points,the intestinal juices were also collected to measure the amylase and lipase expressions.After reinfusion of succus entericus,thelevels of albumin,prealbumin,transferring,and fibronectin were measured at 0,7,and 14 days,ResultsThere was no significant increase of bacteria in the drainage fluid within 4 hours ( F(0,2) =18 812.50,P ＞ 0.05 ; F(0,4) =387 625.00,P ＞ 0.05).and there was no change in the expressions of amylase ( F(0,2) =190.60,P ＞ 0.05 ;F(0,4) =631.75,P＞0.05) and lipase within 4 hours (F(0,2) =204.10,P＞0.05; F(0,4) =1080.05,P＞0.05).After succus entericus reinfusion,the fibronectin (F(0,14) =74.24,P ＜ 0.01 ; F(7,14) =59.78,P ＜0.01),transferring (F(0,14) =0.46,P ＜ 0.01 ; F(7,14) =0.39,P ＜ 0.05 ),and prealbumin ( F(0,14) =54.37,P ＜ 0.05) were increased significantly.ConclusionsBacteria and enzymes do not increase in the drainage fluid within 4 hours in patients with intestinal fistulas.Therefore,it is safe and effective to reinfuse succus entericus.

To apply preventive T-shaped enterostomy in protective defunctioning stoma.Technique of enterostomy closure was only made in abdominal wall rather than abdominal cavity.A total of 78 patients undergoing protective ostomy from January 2005 to April 2012 were divided into two groups of routine enterostomy (group A,n =52) and protective T-shaped enterostomy (group B,n =26).The length of operation and average hospital stay in group A with stoma closure were(98 ± 16) min and (15.3 ± 5.2)days while those of group B (52 ± 9) min and (9.5 ± 2.3) days.The inter-group differences were statistically significant respectively (P ＜ 0.05).Therefore protective T-shaped enterostomy,showing advantages in operative skills,operative trauma and postoperative recovery time,is an effective technique and its application should be further promoted.

Objective To observe the effect of effective monomer of Kangxianling prescription on renal function and extracellular matrix composition of 5/6 nephrectomy rats model, and provide basis for the screening of effective traditional Chinese medicine of anti-renal fibrosis. Methods Sixty SD rats were randomly divided into normal group, model group, chrysophanol group, salvianolate A group, oleanolic acid group and losartan group. The kidney fibrosis model was made by operation. Two months after intervented by correspong drugs, renal pathological changes of all groups were observed, the levels of renal function indexes were detected, and real-time PCR assay was used to detect laminin (LN), fibronectin (FN), type Ⅲ collagen (C-Ⅲ), type Ⅰ collagen (C-Ⅰ) mRNA expression in rat kidney tissue. Results SCr and BUN in model group increased significantly compared with the normal group (P<0.01). SCr and BUN in salvianolate A group decreased significantly compared with the model group (P<0.05, P<0.01). BUN in salvianolate A group decreased significantly compared with the losartan group (P<0.01). The expression of C- ,Ⅲ C-Ⅰand LN were reduced by effective monomer of Kangxianling prescription. Conclusion Effective monomer of Kangqianling prescription can inhibit renal fibrosis through reducing the expression of extracellular matrix components, thereby improve the renal function.

Objective To investigate the result of local injection of growth differentiation factor-5 (GDF-5) and fibrin gel for treatment of lumbar disc injury in rabbits.Methods Lumbar puncture with a 20-gauge needle was performed at L3/4,L4/5,and L5/6 discs of 40 New Zealand white rabbits.After needle puncture,L3/4 discs were injected with GDF-5 and fibrin gel (compound group) ; L4/5 discs fibrin gel (fibrin gel group) ; L5/6 discs nothing (blank control group).Two weeks later,intervertebral disc degeneration in each group was observed via radiography,MRI and nucleus proteoglycan content detection and histological examination.Results At postoperative 2-,4-,8-,and 12-weeks,X-ray films revealed a gradual decrease in disc height index (DHI) among the three groups,but the decreasing velocity was lower in compound group than in other two groups (P ＜ 0.05).On MRI,the signal of intervebral discs among the three groups diminished progressively with time,but a relatively lower decreasing was observed in compound group (P ＜ 0.05).At postoperative 4-week,proteoglycan content of the nucleus pulposus was (6.3-± 0.4) in compound group,higher than (5.9-0.4) in blank control group and (5.8-± 0.3)in fibrin gel group (P ＜0.05).At postoperative 2-week,histological evaluation showed (5.28 ±0.41)points in compound group,lower than (7.54 ± 0.53) points in blank control group and (7.21 ± 0.44)points in fibrin gel group (P ＜ 0.05).Conclusion Local injection of GDF-5 and fibrin gel facilitates the restoration of the injured discs and delays further disc degeneration.

Objective To extract characteristic parameters of ECG signals a new method of non-invasive diagnosis for coronary heart disease with artificial neural network. Methods ECG signals were digitized with A/D converter and filtered to eliminating the noise. Span of QRS interval, R-R interval,and voltage of S-T segment of filtered ECG were detected. These 3 characteristics were as the input parameters of the input layer. Samples were trained with an improved 3-layers back propagation(BP) artificial neural network, as trained samples. The non-trained samples were recognized with these BP neural networks. Results After 12 samples had been trained about 1500 times, the BP neural network could accurately distinguish samples of coronary heart disease from the trained samples and also recognize 20 non-trained samples, 19 to be correct except one. Conclusion It is showed that based on BP network and characteristic parameters of ECG, a new and promising method of non-invasive diagnosis for coronary heart disease has been found.

Objective To investigate the clinical effect and the safety of paroxetine in the treatment of elderly patients with chronic primary insomnia. Methods Ninety elderly patients who met Chinese Classification and Diagnostic Criteria of Mental Disorders, 2nd Rev Ed, (CCMD 2 R) for elderly patients with chronic primary insomnia were randomly divided into paroxetine group (30 cases), alprazolam group (30 cases), and placebo group (30 cases) for 12 weeks as a course. Effects were evaluated with Pittsburgh Sleep Quality Index (PSQI) and treatment emergence symptoms scale (TESS) before and after the 4th, 8th, 12th week of treatment. Results The excellent response rate of paroxetine group and alprazolam group were 83% and 53% respectively( P

Objective To evaluate the impact of preoperative renal artery embolization in renal cell carcinoma patients with venous tumor thrombus.Methods A total of 249 RCC patients with venous tumor thrombus underwent radical nephrectomy and thrombectormy in our hospital.Seventy-four patients received preoperative renal artery embolization while other 175 patients did not.The related items were analyzed.The tumor thrombus level was divided into 5 groups with American Mayo clinic classification system.Considering the significant difference in tumor situation and treatment strategies, we took the hepatic vein as a cut-off line, dividing patients into two subgroups, the early and advanced tumor thrombus groups.There were 208 patients in the early tumor thrombus group and 41 patients in the advanced group.The related items were analyzed respectively.Results Patients in the embolization group tended to have larger tumors and higher percentage of advanced tumor thrombus.For all patients, the embolization group had longer operation time [(4.8 ±2.1) h vs.(4.1 ±2.2) h ,P <0.05] and greater median blood loss (900ml vs 500 ml,P <0.05), compared to the non-embolization patients, and RAE did not show benefits on perioperative outcomes seemingly.However, subgroup analysis of patients with advanced tumor thrombus ( above hepatic vein) , in spite of the larger size of tumor, preoperative RAE showed significant benefits on reducing operation time [(7.0 ±1.7)h vs.(8.2 ±1.8)h, P<0.05)] and intraoperative blood loss (2 000 ml vs.3 000 ml, P<0.05) and decreasing blood transfusion (1 525 ml vs.2 050 ml ,P>0.05).Conclusion Preoperative RAE may be more appropriate for patients with advanced tumor thrombus because of its benefits in reducing operation time, intraoperative blood loss and elevating the operative security.

Objective To study the effects of platelet activation on the metastasis and prognoies of lung cancer. Methods Radio-immunity and ELISA were employed to detect the TXB_2,DH-TXB_2,TSP, β-TG, GMP-140,CGMP and FN of 168 cases of lung cancer patients (lung cancer group) and 80 cases of healthy persons control group. The lung cancer group included two subgroups: earlier and metaphase group (n=51) and advanced group (n=17), 39 cases in the former group underwent operation (after operation group). Results (1)Compared with control group, the levels of DH-TXB2,TSP,β-TG,GMP-140,CGMP in group of earlier and metaphase lung cancer increased and FN decreased. TXB2,DH-TXB2,TSP,β-TG,GMP-140,CGMP in advanced group increased and FN decreased;DH-TXB2 and GMP-140 increased in group of after operation. (2)Compared with group of earlier and metaphase lung cancer,the levels of DH-TXB2,TSP,β-TG,GMP-140,CGMP in group of after operation increased and FN decreased; In advanced group, levels of TXB2, DH-TXB2,TSP,β-TG,GMP-140,CGMP increased and FN decreased. (3)In the lung cancer group, CGMP was positively correlated with DH-TXB2,TSP,β-TG and GMP-140. (4)Compared with control group,TXB2, DH-TXB2, TSP,β-TG,GMP-140 and CGMP in group glandular cancer and small cell carcinoma cases increased,FN decreased;In squamous cancer, the levels of TXB2, DH-TXB2,GMP-140 and CGMP increased and FN decreased. (5)Compared with small cell carcinoma cases, DH-TXB2 decreased in cases of glandular cancer; GMP-140 decreased in squamous cancer. Conclusions Activations of platelet generally emerged with lung cancer patients, platelet activation was severe in advanced cancer patients. Activations of platelet, after operation, is obviously eased. The level of platelet activation marker is possibly related with histological classification of lung cancer.

Objective To investigate the value of cardiac troponin Ⅰ (cTn Ⅰ) in diagnosis of multi-trauma patients combined with myocardiac contusion.Methods A retrospective review was made on 98 cases of multi-trauma patients combined with blunt chest trauma.The groups were identified according to whether the patients were associated with myocardiac contusion or not,including myocardiac contusion group (n =48) and non-myocardiac contusion group (n =50).The detection and diagnosis of myocardiac contusion in the use of different cut-off points of cTn Ⅰ and creatine kinase MB isoenzyme/creatine kinase (CKMB/CK) or their combination were compared between groups.Results cTn Ⅰ ≥0.60 ng/ml had a specificity of 90.0％,a sensitivity of 64.6％ and a Youden index of 0.54 in diagnosis of myocardiac contusion,indicating a best diagnostic accuracy as a single parameter.As compared with the single use of cTn Ⅰ ≥ 0.60 ng/ml or CKMB/CK ≥ 6％ in diagnosis of myocardiac contusion,the combined use of two parameters presented a significantly higher diagnostic sensitivity (85.4％ vs 64.6％ ; 85.4％ vs 27.1％ respectively,both P ＜ 0.05),but no markedly lower specificity (84.0％ vs 90.0％ ; 84.0％ vs 88.0％ respectively,both P ＞0.05).cTn Ⅰ level was positively correlated with ISS score of the multi-trauma patients combined with myocardiac contusion (r =0.534,P ＜ 0.01).Mortality rate in patients with severely increased cTn Ⅰ was much higher than that in patients with mild-moderately increased cTn Ⅰ (P ＜ 0.01).Conclusions cTn Ⅰ ≥0.60 ng/ml presents a high sensitivity and preferable specificity for diagnosis of multiple trauma patients combined with myocardiac contusion.It can be served as a biomarker for diagnosis of MC and its combination with CKMB/CK≥6％ improves the diagnostic sensitivity.cTn Ⅰ can be used as an assessment indicator for the early risk stratification and outcome in multi-trauma patients combined with myocardiac contusion.