Objective To explore the advantages and disadvantages of laparoscopic combined with colonoscopic surgery (double endoscope surgery) and open surgery in the treatment of special types of colorectal polyps. Methods The clinical data of 62 patients with special types of colorectal polyps (wide base sessile, special parts or suspected cancerous, endoscopic resection difficult or high risk) were retrospectively analyzed. Among them, 42 patients underwent double endoscope surgery (double endoscope group), and 20 patients underwent open surgery (open group). The operating time, amount of bleeding during operation, postoperative exhaust time, postoperative hospital stay and complication rate were compared between 2 groups. Results All the patients had successful resection of the polyps, and there were no operative deaths. There was no conversion to open surgery in double endoscope group. Two patients in the open group were unable to locate the lesion by the tactile sensation of the hand and then succeeded in locating by intraoperative colonoscopy. The operating time, amount of bleeding during operation, postoperative exhaust time, postoperative hospital stay and complication rate in double endoscope group were significantly lower than those in open group: (60.5 ± 25.4) min vs. (75.8 ± 20.6) min, (30.5 ± 15.8) ml vs. (55.2 ± 24.6) ml, (24.6 ± 10.5) h vs. (40.5 ± 16.8) h, (3.2 ± 1.0) d vs. (5.8 ± 2.2) d and 0 vs. 20% (4/20), and there were statistical differences (P<0.05). There was 1 case with early postoperative inflammatory bowel obstruction, 1 case with abdominal infection and 2 cases with incision infection in open group. There was no operative death in the two groups, and these patients were cured by conservative treatment. The follow-up time was 3-36 (18.6 ± 12.3) months, and all the patients survived. The patients in 2 groups had no recurrence and metastasis, no anastomotic stenosis, anastomotic leakage and other complications. Conclusions For the special types of colorectal polyps, double endoscope surgery is less invasive, with faster recovery and less complications. It is the first choice except for endoscopic resection.

Objective To investigate the clinical efficacy of laparoscopic versus open omental patch repair for perforated peptic ulcer. Methods One hundred and twenty-seven patients who underwent omental patch repair for perforated peptic ulcer were analyzed retrospectively. There were 74 cases in the laparoscopic repair group (LR group) and 53 cases in the open repair group (OR group) respectively. Operative time, intraoperative blood loss,postoperative pain at 1 d and 3 d.time to first flatus and resumption of diet, time to drainage removal,surgical site infections (wound infection and intra-abdominal abscess),systemic complications and length of postoperative hospital stay were compared. Results LR group experienced less intraoperative blood loss[(32.7 ±25.6) ml], lower postoperative pain at 3 d[(2.8 ±1.5) scores], earlier time to first flatus [ (25.8 ± 20.1) h] and resumption of diet [ (2.7 ±2.1) d ], shorter time to drainage removal [(2.0±1.5) d], less wound infection (0) and shorter hospital stay[(4.8 ±2.3) d] than those in OR group [(53.2±30.0) ml, (36.9±27.9) h, (3.7±2.0) scores, (3.6±2.3) d,(2.9±2.2) d,9.4%(5/53), (6.6±4.0) d](P< 0.01 or <0.05). There were no significant differences in operative time,postoperative pain at 1 d, incidence of intra-abdominal abscess and systemic complications between the two groups. There were no suture-site leakage, reoperation and death in two groups. Conclusions Laparoscopic omental patch repair for perforated peptic ulcer is safe and efficacious. It has significant advantages over open approach with respects of less postoperative pain,earlier return of bowel function,less wound infection and shorter hospital stay.

Objective To make sure whether Bcrp1 is the marker of cervical cancer stem-like cells or not by studying the characterization of Bcrp1+ HeLa cells.Methods Immunofluorescence stained flow cytometry and electron microacope were used to sort and observe uhrastructures of Bctp1+ and Bcrp1- HeLa cells.Flow cytometry wag used to identify the cycle and the rate of apoptosis with annexin V in two group cells.The expression of proliferating cell nuclear antigen (PCNA)and caspase-3 were tested using western blot methed.Results (1)There were 7.1% Bcrp1+ cells and 92.9% Bcrol- cells in HeLa cells.Bcrp1+ HeLa cells were large in size of nuclear and nucleoli are clear.and there were rich of cytomicrosome and rough endoplasmic reticulum.After sorted and cultured for 24,48,72 hours,the adhesion in Bcrp1+ cells were 72.8%,81.1%,80.4%,respectively.While,they were 3.3%,18.7%,12.6%at each time for Bcrpl- cells(all P<0. 05 ). (2) There are more S phase cells in Bcrp1+ cells than that in Bcrp1- cells (54. 1% vs 21.1%, P <0. 05) ,while the percentage of G0/G1 and G2/M in Bcrp1 - cells were highter than those in Bcrp1 + cells (53.0% vs 44. 4% ,25.9% vs 1.5% ; all P <0. 05 ). The rate of apoptosis in Bcrp1+ cells was lower than that in Bcrp1 - cells (0. 2% vs 5.3%, P < 0. 05 ). ( 3 ) The expression of PCNA in Bcrp1 + cells was higher than that in Bcrp1- cells (3140 vs 2255, P< 0. 05 ), while the expression of caspase-3 of Bcrpl + cells was lower than that in Bcrp1 - cells ( 1970 vs 3551, P < 0. 05 ). Conclusion There are more vigor and ability of proliferation and lower rate of apeptosis in Bcrp1 + HeLa cells than those in Bcrp1 - cells ,which may be some characters of cervical cancer stem cells.

Objective To investigate the clinical efficacy of laparoscopy combined with cholangioscopic FREDDY laser lithotripsy for the treatment of difficult central type bile duct calculi.Methods Fifty-five patients with difficuh central type bile duct calculi undergoing laparoscopy combined with cholangioscopy were analyzed retrospectively.There were 31 patients in FREDDY laser lithotripsy group (FREDDY group) and 24 patients in routine instrunent group (routine group).Operative time,intraoperative blood loss,conversion rate,time to first flatus,incidence of postoperative complications (such as pancreatitis,hemobilia and biliary leak),postoperative hospital stay and first session bile duct clearance rate were compared.Results Operative time,intraoperative blood loss,time to first flatus,postoperative hospital stay in FREDDY group [( 106.2 ± 49.4) min,(37.7 ± 28.6) ml,(25.8 ± 19.3 ) h,(5.9 ± 3.3 ) d]were significantly lower than those in routine group[( 142.2 ± 64.8 ) min,(60.3 ± 32.1 ) ml,(37.2 ± 21.6 ) h,(8.4 ±4.9) d] (P＜ 0.05 or ＜0.01 ).There were no statistically significant differences in conversion rate,incidence of postoperative complications and first session bile duct clearance rate between the two groups (P ＞ 0.05).There were no dead in both groups.Seven patients with residual bile duct stones were cured by cholangioscopy through T-tube sinus 6 weeks after prior surgery.Forty-three patients were followed up 6 to 12 months with no recurrent bile duct stones and bile duct stenosis.Conclusions Laparoscopy combined with cholangioscopic FREDDY laser lithotripsy is recommendable to treating difficult central type bile duct calculi with good short-term results and has the advantages of minimal invasiveness,safety,efficiency and rare complications.

Objective: To investigate the effect of fractionated radiotherapy on the immune system of mice with subcutaneously transplanted hepatocellular carcinoma. Methods: Logarithmic growth of mouse hepatocellular carcinoma cells Hepa 1-6 were inoculated subcutaneously on the right side of C57BL/6 J mice (1×10⁷ cells /mice). The tumor-bearing mice were randomly divided into control group (Ctrl) and irradiation group (IR), 20 mice in each group. Additionally, 10 healthy mice were set as normal control group. Local fractionated X-ray irradiation of 8 Gy×3 fraction was given to the subcutaneous tumors, and the dose rate was 0.883 Gy/min. At 7 and 14 d after irradiation, the tumor organ index, spleen organ index, spleen pathological changes, and splenic T lymphocyte subsets, B lymphocyte subsets, and NK cells were detected. Results: Compared with Ctrl, at 7 and 14 d after irradiation, the tumor organ index decreased (t=4.649, 26.34, P<0.05), and the percentage of NK cells increased significantly (t=3.952, 3.633, P<0.05). The percentages of CD3+ , CD4+ , CD3+ CD4+ lymphocytes and the ratio of CD4+ /CD8+ lymphocyte decreased at 7 d after irradiation (t=3.193, 3.656, 3.219, 2.641, P<0.05), and the percentage of CD3+ lymphocyte decreased at 14 d after irradiation (t=3.031, P<0.05). But after irradiation, there were no significant changes in spleen organ index, B lymphocyte, CD3+ CD4+ lymphocyte and CD8+ lymphocyte. Conclusions Local hepatoma radiotherapy causes imbalance of lymphocytes in distal spleen of mice and hence reduces immunity, which provides a novel mechanism of radiological immunity damage.

OBJECTIVETo assess the effects of 1-step method of changing the buccal position of the transported bone after distraction on early bone formation.

METHODSThe custom-made bidirectional distraction devices were used. Total of 8 adult mongrel dogs were procured. The bilaterally mandible premolars were extracted. After 1 month, the complete osteotomy was performed and the devices were placed. The gradual distraction was started after 1 week latency at the rate of 1 mm per day, total 6 mm in height was achieved. The 1-step method of changing the buccal position of the transported bone was performed the day after the vertical distraction period in one side of the animals, and the other side as the controlled side. All animals were killed after a 7 days consolidation. The vascular system was stained post mortem carbon ink perfusion to assess possible damages. Quantitative evaluations of bone density were performed with dual-energy X-ray absorptiometry (DEXA), analysis of the ratio of vascular square was conducted in a computer.

RESULTSAll animals tolerated the procedures well. After vertical distraction, the tested side can be moved 3 mm in buccal direction. DEXA examination showed that the density of the distracted bone was no statistical difference in both the tested and the controlled side. Vascular damage was not observed, and there was no statistical difference in the ratio of vascular square by analyzing the histological section in computer.

CONCLUSIONIn some extent, 1-step method of changing the buccal position of the transported bone after distraction can mold the regenerate bone to correct the axial displacement, without endangering early callus formation and vascularization.

Animals ; Bone Density ; Bone Regeneration ; Bone and Bones ; Dogs ; Mandible ; Osteogenesis ; Osteogenesis, Distraction

Chordotonal neurons are responsible for sound sensation in Drosophila. However, little is known about how they respond to sound with high sensitivity. Using genetic labeling, we found one of the Drosophila axonemal dynein heavy chains, CG9492 (DNAH5), was specifically expressed in larval chordotonal neurons and showed a distribution restricted to proximal cilia. While DNAH5 mutation did not affect the cilium morphology or the trafficking of Inactive, a candidate auditory transduction channel, larvae with DNAH5 mutation had reduced startle responses to sound at low and medium intensities. Calcium imaging confirmed that DNAH5 functioned autonomously in chordotonal neurons for larval sound sensation. Furthermore, disrupting DNAH5 resulted in a decrease of spike firing responses to low-level sound in chordotonal neurons. Intriguingly, DNAH5 mutant larvae displayed an altered frequency tuning curve of the auditory organs. All together, our findings support a critical role of DNAH5 in tuning the frequency selectivity and the sound sensitivity of larval auditory neurons.