Objective To investigate the risk factors and treatment of local recurrence after Dixon operation of rectal cancer.Methods The clinical data of forty-seven patients who had local recurrence after Dixon operation of rectal cancer in our hospital from January 2011 to December 2013 was analyzed retrospectively.According to literature review,the high risk factors and treatment methods of local recurrence of rectal cancer in China and abroad were analyzed.Results The treatment methods of patients with local recurrence after anterior resection were radical resection,palliative resection and chemotherapy.The prognosis of patients with radical resection whose overall survival time was (38.202±2.411) months,better than that with palliative resection ((24.591±2.150) months),better than that with chemotherapy ((12.833±1.033) months).There was a significant difference in the survival time among the three groups (χ2=30.155,P<0.001).Conclusion Fully understanding of high risk factor can help reduce the probability of local recurrence.For patients with local recurrence of the rectal cancer,radical resection should be performed.In case that radical surgery is not possible,positive treatments should be adopted if the patients are in good physical condition.

BACKGROUND:Studies have shown that the application of electrical stimulation of peripheral nerve fibers can recover partial muscle functions due to the loss of central nervous control.
OBJECTIVE:To verify the feasibility of selective nerve excitatory effectively used the symmetric biphasic pulses under the bipolar electrodes stimulation of 1 mm.
METHODS:Eight adult Wistar rats were selected to expose the sciatic nerves after anesthesia and then the electrodes were placed on the sciatic nerves careful y to establish the model of selective nerve stimulation. Experimental electrode was homemade Cuff bipolar electrode, and the electrode stimulators were Grass S88
stimulator and AWG2005 arbitrary waveform signal generator. The two-way dual-electrode stimulation was used. The distance between two electrodes was 1 mm, and the stimulation waveform was symmetric biphasic pulse
with the width of 0.2 ms. The output pulse amplitude, pulse width and delay could be adjusted. The stimulation
intensity was adjusted, and the law of nerve excitability was detected under two-way dual-electrode stimulation, in order to achieve selective nerve excitability, and the feasibility of two-way dual-electrode stimulation to achieve
selective nerve excitatory was verified with“col ision”method.
RESULTS AND CONCLUSION:The change of nerve action potential was amplified by P511 amplifier and then linked into oscil oscope for displaying, and dual-electrode stimulation waveform was the symmetric biphasic pulse with the width of 0.2 ms. With the increasing of stimulus amplitude, we achieved the selective nerve excitatory. The results indicate the selective nerve excitatory can be achieved with the closed (1 mm) dual-electrode symmetric pulse, and the feasibility and effectiveness of this method can be verified with“col ision”principle.

Objective To study the change of levator urethra gap(LUG) in postpartum female using pelvic floor three-dimensional ultrasonography.Methods Totally 80 postpartum women and 30 nulliparas were examined by three-dimensional pelvic floor ultrasonography.The images were obtained at maximal pelvic floor muscle contraction,and then the morphology of puborectalis muscle on tomographic ultrasound imaging were observed and the right LUG and left LUG were measured.Results The puborectalis was intact in all nulliparas and 69 postpartum women.The puborectalis avulsion was find in 11 postpartum women.The LUG of postpartum group was greater than that of nullipara group (P ＜0.05).In postpartum group,the LUG of puborectalis avulsion was greater than that of intact puborectalis(P ＜0.05).There was no difference between the right LUG and left LUG in nullipara group and in the postpartum women with intact puborectalis (P ＞ 0.05).ConcIusions LUG is a good imaging parameter to evaluate the levator avulsion in postpartum women.

Objective To find the key miRNA that relative to peritoneal fibrosis associated with peritoneal dialysis (PD) by microarray technology,and verify its expression in vitro and in vivo.Methods The peritoneal fibrosis mouse model associated with PD were established by intraperitoneal injection of lipopolysaccharide (LPS)+ 4.25％ peritoneal dialysate.The expression of miRNA was detected by microarray in peritoneal tissues.The expression of miRNA profiles between fibrotic and normal peritoneal tissues was compared.The differentially expressed miRNA (miR-200a) was validated by real-time PCR in lager sample size cohorts.The expressions of miR-200a were also detected in the epithelial-mesenchymal transition (EMT) process of human peritoneal mesothelium cells.Results In mice model of PD,peritoneal tissue was markedly thickened and with a massive extracellular matrix accumulation.In contrast with control,the expression level of epithelial marker E-cadherin was significantly decreased,α-SMA,Col-Ⅰ and FN were remarkably increased (P ＜ 0.05).By miRNA microarray analysis,miR-200a was significantly down-regulated (3.31 folds change,P ＜ 0.05) in fibrotic peritoneal tissues.The down-regulated expression level of miR-200a was also validated by realtime PCR in larger cohorts (P ＜ 0.05).Then,the expression level of miR-200a was detected in the EMT process of human peritoneal mesothelium cells.During the process of TGF-β1 induced EMT,miR -200a was significantly down-regulated compared with the control (P ＜ 0.05).Conclusions Downregulated expression of miR-200a was observed both during peritoneal fibrosis and TGF-β 1 induced EMT in vivo and in vitro,suggesting that miR-200a may be involved in the peritoneum fibrosis by regulating the target genes of EMT.

BACKGROUNDTo investigate pathologically the characteristics of proximal bronchial invasion of lung cancer, and to provide the theoretic basis for the selection of a proper operation mode.

METHODSA total of 398 patients with lung carcinoma underwent radical pulmonectomy and systematic lymphadenectomy. The proximal bronchi and the hilar and mediastinal lymph nodes of their operatively resected specimens were selected for pathological study.

RESULTS(1)The direct invasion of cancerous cells through mucous, submucous or multiple layers was the most frequent way during lung cancer spread, rating 9.3%, 21.8% and 68.9% respectively. 96.4% of the cancerous invasion occurred at the proximal bronchial wall less than 1.5 cm apart from the cancer margin. The extension of invasion correlated with the histopathologic type of cancer, mode of invasion and TNM classification. (2)The cancer infiltration by the nodes metastasizing into the bronchus wall (bronchial external tunica or cartilage) was also an important way for the cancer to spread, especially in adenocarcinoma. The poor differentiated adenocarcinoma has significantly higher metastatic rate and infiltration rate than the well differentiated ( P < 0.01, P < 0.01). There were 22 such cases, including 3 of lobar bronchus wall invaded by N1 metastasis and 19 of main bronchus wall by N2 metastasis.

CONCLUSIONSFor radical removal of tumor, the key point for selecting a rational operation mode is to keep a distance of 1.5 cm or more between the excision margin of the bronchus and the tumor, to pay attention to the bronchial wall invasion caused by the metastatic lymph nodes, even in peripheral adenocarcinoma, and to dissect extensively and completely the lymph nodes of the hilar and upper and lower mediastinum at the homolateral thoracic cavity.

OBJECTIVETo investigate risk factors associated with lymph node metastasis and prognosis of rectal neuroendocrine tumor (NET).

METHODSClinicopathological data of 69 patients with rectal NET in our department from April 2003 to October 2011 were retrospectively analyzed. Associations of clinicopathological factors with lymph node metastasis and prognosis were examined using univariate and multivariate analysis.

RESULTSOf the 69 patients, 9 cases had lymph node metastasis. The lymph node metastasis was significantly associated with tumor size, T stage and G grade by univariate analysis. Multivariate analysis showed that T stage was the only risk factor associated with lymph node metastasis. The overall 5-year survival rate was 90.3%. Prognosis of rectal NET was significantly associated with tumor size, T stage, N stage, M stage, TNM stage and G grade by univariate analysis. Multivariate analysis showed that M stage was significantly associated with long-term survival in rectal NET patients (P=0.000, HR=2.285, 95%CI:1.484~3.518). There was no significant difference in patients with stage I between local and radical resection, while there were significant differences in those with stage II or higher between the two operations (P=0.046).

CONCLUSIONT stage is associated with lymph node metastasis and both TNM stage and M stage can affect the prognosis of patients with NET, which may be used as potential predictive factors for rectal NET. Local resection should be recommended for patients with stage I and radical resection should be recommended for patients with stage II or higher.

Adult ; Aged ; Female ; Humans ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; diagnosis ; pathology ; Male ; Middle Aged ; Neoplasm Staging ; Neuroendocrine Tumors ; diagnosis ; pathology ; Prognosis ; Rectal Neoplasms ; diagnosis ; pathology

OBJECTIVETo detect structural changes in the brain in fetuses with agenesis of the corpus callosum (ACC) and holoprosencephaly (HPE) in the first trimester.

METHODSThe ultrasound data were analyzed retrospectively in 620 normal singleton fetuses between 11 and 13(+6) gestational weeks, 5 fetuses diagnosed to have ACC, and 13 fetuses with HPE. The midbrain diameter (MD) and falx diameter (FD) were measured and their ratio (MD/FD) was calculated for comparative analysis.

RESULTSNo significant difference was found in the MD, FD, and MD/FD ratio between fetuses with ACC and HPE (P>0.05). Compared to the normal fetuses, all the fetuses with ACC and HPE showed significantly increased mean MD and MD/FD ratio (P<0.05); 4 (80%) fetuses with ACC and 11 (84.6%) with HPE had a reduced FD. All the fetuses with ACC and HPE had MD/FD ratios greater than 1, which were below 1 in all the normal fetuses.

CONCLUSIONIn the first trimester, fetuses with ACC and HPE have measurable abnormalities in the midbrain and falx area of the brain, and these changes, represented by abnormal midsagittal MD, FD and their ratio, can be of value in detecting ACC or HPE in fetuses in the first trimester.

Agenesis of Corpus Callosum ; diagnosis ; Corpus Callosum ; diagnostic imaging ; Female ; Fetus ; Gestational Age ; Humans ; Pregnancy ; Pregnancy Trimester, First ; Retrospective Studies ; Ultrasonography, Prenatal

Objective To investigate the significance of circulating tumor cells in tumor reflux venous blood in colorectal cancer patients with liver metastasis.Methods Seventy-four patients with colorectal cancer treated in Liaoning Cancer Hospital & Institute from January 2015 to January 2017 were enrolled in this study.The circulating tumor cells were detected by CellSearch system in patients with tumor reflux venous blood to analyze the results of circulating tumor cells and their clinical significance.Results Among the 74 patients with colorectal cancer,there were 24 patients with synchronous liver metastasis and 9 patients with metachronous liver metastasis.The sensitivity of CEA and CA19-9 positive in the detection of colorectal cancer synchronous liver metastasis was 67.9% and 58.6%,respectively.The sensitivity of circulating tumor cells positive detection in tumor reflux venous blood in the diagnosis of synchronous liver metastasis was 60.6%.n patients with metachronous liver metastases,CEA and CA19-9 positive patients were 33.3% and 55.6%,respectively,while CTCs positive patients were 77.8%.Conclusion The detection of circulating tumor cells in tumor reflux venous blood of colorectal cancer not only improves the detection rate,but also may become a predictive factor for metachronous liver metastasis.

Objective To Establish a loop-mediated isothermal amplification(LAMP)assay for detection of Salmonella in fecal samples of tree shrews, and report the result of preliminary application of this method. Methods LAMP primers were designed and synthesized according to the conserved sequence of Salmonella specific gene invA (invasive protein gene A). To optimize the reaction time and temperature by setting 10 reaction times(24 to 42 min)and temperature(57℃ to 66℃)and tested its specificity and sensitivity. At the same time, a conventional PCR test was performed to verify and compare with the LAMP assay. 91 fecal samples of wild-derived tree shrews were detected by the LAMP assay. Results The experimental condition was confirmed as 62℃ and 34 min. The sensitivity of Salmonella was 3.36×101CFU/mL, which was 10 to 100 times higher than that of conventional PCR assay. In 10 kinds of intestinal bacteria for LAMP amplification,Salmonella enteritidis and Salmonella paratyphi B were positive,the others were negative. Among the 91 samples of tree shrew fecal samples detected by the LAMP assay, the positive detection rate was 20.88%. The LAMP assay can be completed within 40 min, the result can be observed and judged visually by color changes. Conclusions The LAMP assay established in this study is convenient,rapid,sensitive and specific. It can be used as a rapid measure for large-scale detection of Salmonella in feces of tree shrews.