Objective To investigate the value of the three-dimensional endorectal ultrasonography (3D-ERUS) in the tumor staging before transanal endoscopic microsurgery (TEM).Methods The clinical data of 30 patients with rectal cancer who underwent 3D-ERUS before TEM at the Nanjing Hospital of Traditional Chinese Medicine from April 2012 to December 2013 were retrospectively analyzed.The accuracy,sensitivity and specificity of the 3D-ERUS were evaluated according to the results of the postoperative pathological examination.The consistency of the results of the 3D-ERUS and postoperative pathological examination were compared by Kappa consistency test.Results Of 30 patients,25 patients in stage T0,3 in stage T1 and 2 in stage T2 were diagnosed by preoperative 3D-ERUS.There were 2 patients (stage pT0) with inflammatory polyp by postoperative pathological diagnosis,6 patients (stage pT0) with tubular adenoma,16 patients (stage pT0) with villioustublar adenoma,2 patients (stage pTis) with carcinoma in situ,2 patients (stage pT1) with tectal adenoma and 2 patients (stage pT2) with rectal adenoma.There were 2 patients with excessive tumor staging by 3D-ERUS,1 patient in stage pT0 was misdiagnosed in stage T1,1 in stage pT1 was misdiagnosed in stage T2 and 1 in stage pT2 was misdiagnosed in stage T1 with insufficient tumor staging.The accuracy of 3D-ERUS in the preoperative tumors staging of TEM was 90.0％ compared with the resuls of postoperative pathological examination.The accuracy,sensitivity and specificity of 3D-ERUS in stage pT0,pTl,and pT2 of TEM were 96.7％,90.0％,93.3％ and 96.2％,50.0％,50.0％ and 100.0％,92.8％,96.4％,respectively.There was a significant difference in the consistency between preoperative 3D-ERUS and postoperative pathological examination (κ =0.685,P ＜ 0.05).Conclusion 3D-ERUS is an accurate clinical method in the preoperative tumors staging of TEM,and can be used as the preoperative assessment for TEM.

OBJECTIVE To search for available mode of oral apparatus′s disinfection and management.METHODS To use new ways of oral apparatus′s disinfection and management that are enhancement of recognition,normal disinfecting procedure,available disinfection room,enhancement of management,new management system,building digitizing management and so on.RESULTS To build effective system and decrease abrasion and uselessness of oral apparatus.CONCLUSIONS Effective disinfection and management are very important for prevention of the cross infection and ensuring of daily use of oral apparatus.

Objective To investigate the intervention of trans-theoretical model on the risk factors in the patients with prediabetes.Methods One hundred and twenty-two patients with pre-diabetes in a tertiary hospital of Zhengzhou City were selected and randomly assigned to control group and intervention group.The control group received the routine diabetic health education,while in addition to the routine health education,the intervention group was assisted by TTM interventional measures.The blood glucose,body mass index(BMI) and negative emotion were compared between the two groups.Results The blood glucose and BMI after intervention in the two groups were decreased,moreover the decrease level of fasting blood glucose and BMI in the intervention group was higher than that in the control group,and the difference was statistically significant(t=4.963、2.061,P＜0.05).The anxiety and depression emotion scores after intervention in the intervention group were [(3.47 ±1.07) and (0.30 ± 0.46)],before intervention were (7.74 ± 4.00) and(7.25 ± 4.50),The difference was statistically significant(P＜0.05),Moreover the anxiety and depression emotion scores after intervention in the intervention group were lower tghan those in the control group with statistical difference(t=3.300、2.054,P＜0.05).Conclusion The intervention measures based on TTM has significant advantage for controlling the risk factors of pre-diabetes and preventing diabetes than the conventional health education.

Objective To compare the clinical effect, hematopoietic reconstitution, and adverse effects of compatriots HLA in the same period with haploidentical allogeneic hematopoietic stem cell transplantation among relatives for treatment of haematological malignancies. Methods 9 patients of compatriots HLA and 9 patients of haptoidentical allogeneic were recruited. The clinical effect, hematopoietic reconstitution, and transplant-related adverse effects of the observation groups were retrospectively analyzed. Results There was no statistical difference between the clinical effect in two groups, hematopoietic reconstitution, pretreatment-related toxicity and acute and chronic GVHD. The infusion volume of blood products, CMV infection and fungal infection in haploidentical transplant group was higher than that in compatriots HLA group. Conclusion HLA haploidentical family donor transplantation is a good way to increase the source of donor for the treatment of haematological malignancies.

Objective To observe the curative effect of imatinib mesylate combined with myeloablative allogeneic hematopoietic stem cell transplantation for treatment of chronic myeloid leukemia advanced phase. Methods To retrospectively analyze clinical effect of 6 patients with chronic myeloid leukemia advanced phase were treated with imatinib mesylate combined with myeloablative allogeneic hematopoietic stem cell transplantation from July 2005 to April 2009, and literature review. Results The disease-free survival and the survival rate of 4 patients were 66.67 %. 2 patients died (one case die for Chemotherapy pretreatment in the third transplantation after two years, the other case die for Chemotherapy pretreatment in the second transplantation after six months ). Conclusion The clinical cure rate of chronic myeloid leukemia advanced phase may be improved with the treatment of imatinib mesylate combined with myeloablative allogeneic hematopoietic stem cell transplantation.

Objective To observe the biomechanieal properties of tendons repaired by five suture techniques in different stage of healing process.Methods After establishing the zone Ⅱ FDP transection model in 2nd,3rd,4th too of both feet in female fowls,the ruptured tendons were repaired with Modified Kessler ( M K ),Kessler plus running ( K +R ),double-strand Kessler ( DK ),double loop (DT) and modified double loop (MT) methods,respectively.Passive and active mobilizations were applied on the 3rd day and 21st day postoperatively.Animals were executed postoperatively,on the 14th,21st and 35th days,respectively and both feet were harvested for biomechanical test.Results Anatomical findings included: The breakage incidence of K+R group was smaller than that of MK group.The excellent and good results of K+R and DK groups were higher compared with that of MK group.Biomechanical results showed: The MK group had the poorest biomechanical results in every stage of tendon healing (P＜0.05) except that the results from MK group on the 35th showed no statistical difference compared with that of MT and DT in extreme load;K+R group exbited the greatest extreme load and tensile strength (P＜0.05);Biomechanical test results from all groups showed significant differences on different testing point: 35th day＞21st day＞14th day(P＜0.05 );No significant differences were found in all groups between the immediate postoperative results onlst day and that from 14th day.ConclusionDuring the recovery of tendon,biomechanical properties returned to the immediate postoperative level on the 14th day and increased along with time.K+R group shows the superiority to the other methods in biomechanical properties as well as low breaking incidence ratein every stage of tendon healing.Kessler plus running is an effective method with high strength against breakage and great resistance to adhesion formation.

Objective To compare the clinical efficacy between supine position and latericumbent position on Asian proximal femoral nail anti-rotation (PFNA-Ⅱ) fixation for femoral intertrochanteric fracture in elderly patients.Methods A retrospective case control study was conducted to analyze the clinical data of 128 patients with intertrochanteric fractures admitted from January 2016 to January 2017.There were 49 males and 79 females,aged 65-100 years,with an average of 83.2 years.According to AO classification of fracture,there were 27 cases of type A1,82 cases of type A2,and 19 cases of type A3.The patients were divided in to supine position group at traction bed (66 cases) and latericumbent position group at regular bed (62 cases) according to the operative position.The two groups were treated with Asian PFNA-Ⅱ internal fixation.The position time,incision length,operation time,intraoperative blood loss,ambulation time without load,fracture healing time,and Harris score of hip function at the last follow up were compared between the two groups.Complications were recorded.Results All patients were followed up for 12-18 months,with an average of 13.5 months.There were no significant differences between the two groups inambulation time without load,fracture healing time,and Harris score of hip joint function (P ＞ 0.05).In the supine position group and the latericumbent position group,respectively,the position time was (13.6 ± 2.3)minutes and (6.4 ± 1.6) minutes,the incision length was (7.8 ± 1.9) cm and (6.5 ± 1.4) cm,the operation time was (51.3 ± 4.1) minutes and (45.5 ± 5.5) minutes,the intraoperative blood loss was (99.5 ± 3.5) ml and (82.1 ±3.5) ml (P ＜ 0.05 or 0.01).All patients were healed without complications such as coxa varus,internal fixation loosening or fracture.Conclusion The Asian PFNA-Ⅱ internal fixation in the latericumbent position for senile intertrochanteric fractures has the advantages of simple procedure,less trauma,shorter operation time,and less bleeding,which is worthy of promotion.

ObjectiveTo analysis the epidemic tendency of the methicillin-resistant Staphylococcus aureus(MRSA).MethodsClinical data of patients from August 2004 to August 2005 were analyzed retrospectively.Results62 Staphylococcus aureus were isolated,and the MRSA isolated rate was 59%.The MRSA patients tended to complex infection.ConclusionThe infection caused by MRSA is serious.It is necessary to take effective measures to control the MRSA prevalence.

OBJECTIVETo detect common environmental pollutants in human body.

METHODSUrine samples were collected from 80 healthy subjects. Chromatography mass spectrometry (GC-MS), HPLC and ELISA were applied to detect several common environmental pollutants in urine samples.

RESULTSDBP and methylbenzene were present in 75.3% and 41.2% of urine samples. The methanal and AFM1 were found in most of urine samples (approximately 91≊97%). By contrast, PCBs, CPZ, 4, 5-DCC were found in less than 5 samples, but there was no TMT detected.

CONCLUSIONSome of the environmental pollutants including carcinogens are detected in urine samples in this study.

Objective To compare the biomechanical effect of several commonly used internal fixators in treating the femoral neck fractures so as to provide clinical basis for the selection of ideal internal fixation.Methods Twelve artificial PMMA femoral models were selected,and the central neck of the specimens was sawn with an electric saw at Pauwels angle of 70° to form adduction type femoral neck fracture models.After anatomic reduction,the specimens were fixed with dynamic hip screw ( DHS),three hollow screws,proximal femoral nail (PFN) and dynamic sleeve three-wing screw according to the operative approach,respectively.Instron-8874 servo-hydraulic mechanical testing machine was used to fix the specimens which simulated uniped standing.Fifteen key points on proximal femur were selected as test points and were given gradation loading at speed of 10 mm/min with linear load 0-1 200 N.The strain of each point under 1200 N load,head sink displacement under different loads and the strain of eight points on principal pressure side were measured.Results There was a peak at the eight resistance strain gage at 1200 N load and the strain values of the DHS,three hollow screws,PFN and dynamic sleeve three-wing screw were (700 ±35) μεz,(756 ± 14) με,( 1362 ± 136) με and (3024 ± 127) με,with statistical significance (P ＜ 0.01 ).Under the same load,the head sink displacement in the group of dynamic sleeve three-wing screw was greater than that of the hollow screws group and the PFN group ( P ＜0.01 ),but smaller thau that of the DHS group ( P ＜ 0.01 ).The strain values at the eight resistance strain gage in the group of dynamic sleeve three-wing screw was larger than that of the other three groups under the same load (P ＜ 0.01 ),and the strain values increased with the increase of load at the same fixation group.Conclusion Dynamic sleeve three-wing screw has good biomechanical stability for treatment of femoral neck fracture,which can be applied in the clinical practice.