Objective To investigate the short-term outcomes and oncological safety of laparoscopy resection for colorectal cancer. Methods Between January 2004 and March 2009, 35 patients with colorectal cancer underwent laparoscopic-assisted surgery in our hospital, among which 32 underwent radical resection, 1 underwent laparoscopic exploration, and 2 were converted to open surgery. These patients were allocated in the laparoscopic group. Same numbers of patients who underwent conventional open surgery during the same period of time were identified and allocated in the open group. Short-term data, including surgical time, intra-operative blood loss, intra-operative blood transfusion, length of incision, histopathological data, post-operative complications and post-operative functions, were collected and compared between the two groups. Results A total of 67 patients were enrolled (32 in both laparoscopy and open groups). The other 3 cases were analyzed separately (1 underwent laparoscopic exploration and 2 converted to open surgery). The two groups were well balanced as to age, gender, and TNM staging and location of tumour. Histopathologically, the laparoscopic approach was equal to conventional approach as regard to resection margin (distal margin, 5 cm vs 5 cm, P=0.664) and lymph node yield (7 vs 8, P=0.228). This study also showed a longer surgical time (250 min vs 180 min, P=0.006), but shorter length of incision (10 cm vs 20 cm, P<0.001), less demand of intra-operative blood transfusion (1 case vs 10 cases, P=0.003), reduced use of analgesics (12 cases vs 25 cases, P=0.004), shorter post-operative stay (9.5 days vs 11 days, P=0.008) and earlier recovery of bowel function of the laparoscopic group. There was no statistical difference of intra-operative blood loss (200 mL vs 200 mL, P=0.098), incidence of post-operative complications (8 cases vs 6 cases, P=0.545) and volume of post-operative negative drainage (507.5 mL vs 669.0 mL, P=0.475) between the two groups. Conclusions Though limited by a relatively small sample size, our study showed that laparoscopy approach for colorectal cancer is equal to open approach in terms of oncological safety and short-term outcome.

ObjectiveTo investigate the effects of atorvastatin on cardiomyocyte apoptosis and caspase-3 expression in acute myocardial infarction in rats.MethodsFifty SD rats were randomly divided into 3 group:sham group,control group( normal saline),atorvastatin pretreatment group ( 10mg/kg),The atorvastatin group were pretreated with atorvastatin ( 10mg/kg ) for 3 days,and those in the control group were pretreated with normal saline instead.All rats underwent coronary ligation of left anterior descending branch to establish AMI rat s model on the fourth day except the sham group,while sham group only received thoracotomy without coronary ligation.Then,The infarct size area at risk were defined by Evans blue and TTC staining,the caspase-3 mRNA expression of myocardium was measured with reverse-transcriptase polymerase chain reaction(RT-PCR) and the apoptosis index was analyzed by TUNEL staining.Results Compared with control group,the infarct size,the caspase-3 mRNA expression of myocardium,the apoptotic index were decreased significant in the atorvastatin group ( P ＜ 0.05 ).ConclusionPretreatment with atorvastatin has protective effect on the acute ischemic cardiomyocytes,which may probably be associated with the reduction of the expression of caspase-3 mRNA in the myocardium and the apoptotic index.

Objective To investigate the expression of visfatin mRNA in abdominal omental adipose tissue and its relationship with blood lipid in type 2 diabetes mellitus.Methods 161 type 2 diabetic patients were divided into two groups according to triglyceride ( TG ),high triglyceride group ( TG ≥ 1.7mmol/L) and normal triglyceride group(TG ＜ 1.7 mmol/L).The expression of visfatin mRNA in abdominal omental adipose tissue was measured with Northern Blot.Visfatin plasma concentration,fasting plasma glucose (FPG),blood lipid profiles and other biochemical indicators were also measured.Results Comparing with normal triglyceride group,the diabetic patients in high triglyceride group had significantly increased levels of visfatin plasma concentration [ ( 129.07 ± 21.35)ng/mL vs ( 101.65 ± 15.23 ) ng/mL,t =2.295,P ＜0.05]and mRNA expression in omental adipose tissue( P ＜0.05).Visfatin plasma concentration was positively correlated with TG( β =0.592,P ＜0.05 ) and FPG( β =0.763,P ＜0.01 ).Visfatin mRNA expression in omental adipose tissue had no correlation with FPG,TG and other biochemical indicators.Conclusions The plasma visfatin level in T2DM patients may be associated with triglyceride metabolism.

Objective The risk of ovarian/pelvic serous cancer can be reduced by prophylactic bilateral salpingectomy ( PBS) at the time of hysterectomy .This study was to evaluate the short-term influence of PBS plus hysterectomy on ovarian reserve in premenopausal women . Methods We retrospectively analyzed the clinical data about 60 premenopausal women treated by total lapa-roscopic hysterectomy ( TLH) for benign indications , 30 undergoing PBS at the same time ( the experimental group ) while the other 30 with the ovary preserved ( the control group ) .We compared the levels of FSH, LH, E2, and anti-Müllerian hormone ( AMH) and the inci-dence of peri-menopausal symptoms between the two groups of patients before and at 1 and 3 months after operation . Results Statistically significant differences were not observed between the two groups in the such baseline clinical characteristics as age , gravidity, parity, men-strual cycle, comorbidity, diagnosis, comorbidities, and history of abdominal surgery (P>0.05), nor in the AMH level at the baseline ([1.08±0.08] vs [1.04±0.10] ng/mL) or at 1 month ([0.86± 0.44] vs [0.81±0.48] ng/mL) or 3 months postoperatively ([0.84±0.94] vs [0.68±0.42] ng/mL) (F=0.247, P=0.746).Howev-er, the mean level of AMH was markedly reduced at 1 and 3 months after operation as compared with the baseline ( P<0.05) , though with no significant difference between 1 and 3 months ( P>0.05) .There were not any statistically significant differences in the levels FSH, LH, and E2 between the two groups before or at 1 and 3 months after surgery (P>0.05), nor in the incidence rates of peri-menopausal symptoms at 1 month (6.7%vs 3.3%, P>0.05) or 3 months postoperatively (10.0%vs 6.7%, P>0.05). Conclusion PBS at the time of total hysterectomy in premenopausal women does not affect ovarian reserve in the short term .The level of AMH has a higher sensitivity than those of FSH , LH and E2 in the assessment of postoperative ovarian function .

Objective To investigate the relationship between bone mineral density (BMD) and the changes of serum adiponectin (APN) level in elderly men.Methods A total of 240 elderly men was enrolled in this study.Measurement of BMD of lumbar spine with dual energy X-ray absorptiometry was performed.All subjects were divided into three groups (normal,osteopenia,and osteoporosis) according to the T value of BMD.Serum APN level was tested using enzyme-linked immunosorbent assay (ELISA),meanwhile were recorded as bone lurnover markers.Results (1) The level of serum APN in osteopenia group was lower than in normal group,the level of serum APN in osteoporosis group was significantly lower than in osteopenia group,while the level of serum APN in osteoporosis group was significantly lower than in normal group (all P ＜ 0.05).(2) Serum APN was positively correlated with T value of BMD (r =0.475,P ＜0.01).(3) The stepwise multiple linear regression analysis showed serum APN,25-hydroxyvitamin D,β-isomerized carboxyterminal propeptide (β-CTX),and osteocalcin could enter into the equation.Conclusions Serum APN might play an important role in pathogenesis of osteoporosis in elderly men.

Objective To discuss the efficacy and safety of triamcinolone acetonide (TA)retrobulbar injection combined with panretinal photocoagulation (PRP)in the treatment of diabetic macular edema (DME), and to explain the advantages of this combination treatment method in treating DME.Methods Sixty-four cases (64 eyes) with macular edema due to diabetic retinopathy(DR)were randomly divided into combination treatment group(n=34,treated with TA retrobulbar injection combined with PRP)and PRP group(n=30,received PRP treatment only).The changes in the best corrected visual acuity (BCVA), the fovea centralis thickness (CMT), and the intraocular pressure(IOP)before treatment and in 1 month, 3 months, 6 months after treatment were compared. Results The BCVA was improved in both groups after treatment. However, the BCVA improvement in combination treatment group was statistically more significant (P<0.05)compared with PRP group in 1 month, 3 months and 6 months after treatment. The resolution of DME after treatment as compared with that before treatment,the CMT reduced in two groups in 1 month,3 months,6 months after treatment.At each stage,the CMT in combination treatment group was lower than PRP group (P<0.05 ). No complications of glaucoma, cataract,vitreous hemorrhage,retinal detachment,choroidal detachment,and endophthalmitis were found in all patients.Conclusion For the patients with DME,the combination treatment with TA retrobulbar injection and PRP has a better therapeutic effect than the sole PRP treatment in reducing the macular edema and improving the BCVA.The operation is simple and has less complication.

Objective To explore the relationship between the level of morning blood pressure surge (MBPS) and High-sensitivity C-reactive protein( hs-CRP) in acute coronary events among old patients and to evaluate their clinical value. Methods One hundred and twenty - three patients with coronary disease were divided into two groups, each of which was old myocardial infarction(OMI, n = 55) and old myocardial infarction with acute cardiovascular syndrome (OMI + ACS, n =68). The control group includes the patients without coronary disease( n =50). The patients who have infection, malignant tumors, liver and kidney dysfunction, blood diseases, valvular heart diseases, congenital heart diseases, aortic dissection,secondary hypertension were not included. All groups were received 24 hours ambulatory blood pressure monitoring to calculate MBPS and the determination of hs-CRP in serum. Results Compared with each two groups, the levels of MBPS and hs-CRP in OMI group were significantly higher than those of the control group (0. 01 ＜ P ＜0. 05) , and had more significance in the other groups ( P ＜0.01). The levels of MBPS and hs-CRP had positive relationship in coronary events in the elderly ( r =0. 76, P ＜0. 01) . Conclusion The level of MBPS is positively correlated with serum hs-CRP which is one of key risk factors of inflammatory reactions by impairing vessels in body. The two factors both play important roles in the occurrence and the development of coronary events among old patients. They both have important clinical value in recurrent acute coronary events among old patients.

Objective To investigate CT features and the staging of the ovarian cystadenocarinoma.Methods The CT findings of 73 ovarian cystadenocarcinomas proved by surgery and pathology in 52 cases were analyzed.CT staging in 41 cases with whole abdominal scan was made and the CT finding was compared with operative results.Results Of 73 ovarian cystadenocarcinomas,23(31.5%) tumors were typeⅠ(mainly cystic),32(43.8%)tumors were type Ⅱ(mixed) and 18(24.7%) tumors were type Ⅲ(mainly solid).The preoperative stage accuracy for stage Ⅲ patients was 90.9%.Conclusion CT manifestations of ovarian cystadenocarcinoma are varient,the definite diagnosis can be made by typical appearance.CT scan has a high accuracy in staging of preoperative.

Problem-based learning (PBL) is a student-centered pedagogy in which a subject is approached in the context of realistic problems.We have applied PBL into intemnal medicine of general medicine for up to three years.The results suggest that the PBL method could promote the clinical competencies and self-learning capacities of students.However there is still room for improvement.

Objective:This study aims to ensure the private hospitals development strategy in the background of new healthcare reform and put forward some scientific suggestions to help promote their sustainable development. Methods:The SWOT analysis method was adopted to analyze the private hospitals’ internal strength, weakness, exter-nal opportunity and threats. Results: The results showed a clear property right, advanced management system and other outstanding advantages in the private hospitals. Opportunities like the improved policy environment and people’s medical demand expansion are also very prominent. Meanwhile, the private hospitals development also faces some disadvantages and challenges such as illegal operation, disorder in the market competition, vague orientation, etc. Conclusions:It suggests the strengthening of the personnel and hospital culture construction, adoption of the differen-tiation strategy, improvement of the diagnosis and treatment ability, etc.