ObjectiveTo evaluate the effect of radical proctectomy with TME for the treatment of rectal carcinoma in the prevention of postoperative local recurrence. Method78 patients undergoing this procedure were followed up for 5 years.ResultLocal recurrence developed in 10 cases during 5 year′s follow up, with recurrence related mortality of 7/78, local recurrence rate of 10/78 (13%). Tumor malignancy and Dukes′ grade were in direct proportion with the recurrence. The 5 year′s survival rate was 88%(69/78). The postoperative 5 year′s survival rate in Dukes′ A, B and C patients was respectively 100%(9/9), 92%(51/54), and 64%(9/14). ConclusionRadical proctectomy with TME is superior to that without TME in terms of low postoperative local recurrence rate for the treatment of rectal carcinoma.

Objective To investigate the expression of p21-activated kinase 1 (PAK1) protein in patients with colorectal carcinoma and evaluate its clinicopathological significance. Methods The expression of PAK1 was detected by the immunohistochemical method (SABC) in 50 cases of colorectal carcinoma and pericancerous normal specimens, and the relationship between the expression of PAK1 protein and clinicopathological parameters was analyzed. Results The positive rate of PAK1 in colorectal carcinoma was significantly higher than that in normal pulmonary tissues (58 % vs 22 %, P <0.01), and the expression of PAK1 protein was significantly correlated to lymph node metastasis (χ2 =8.872, P =0.003) and degree of differentiation (χ2 =6.344, P =0.042), but not to tumor location, size, age and sex (P >0.05). The positive staining of PAK1 protein was mainly located in the cytoplasm of tumor cells. Conclusion Overexpression of PAK1 is closely related with tumor biological behavior and it may play important role in the development of colorectal carcinoma.

Objective To investigate the role of hydroxyapatite nanoparticle (nHAP) in the gene transfection of human colorectal cancer cell line SW480/M5 and the possible mechanisms.Methods The combination and protection of nHAP-Mg2+ to DNA were analyzed by gelose gelatin electrophoresis.Liposome and nHAP modified by magnesium chloride was combined,and the PEGFP-N1 plasmids were transfected into SW480/M5 cells.The gene transfection rate and the mean fluorescence intensity were observed by flow cytometry.The effect of nHAP-Mg2+ on the growth of the cells were studied by MTT.Results At appropriate proportion,nHAP-Mg2+ could combine the plasmids compeletly and protected the DNA.The gene could not be transferred by nHAP-Mg2+ alone.Combining the nanoparticles and liposome,the gene could be transferred very efficiently and the transfection rates were significantly higher than the liposome (P ＜ 0.05).The inhibition of cell growth was increased along with the concentration of nHAP-Mg2+ wether it was used alone or with the combination of liposome (P ＜ 0.05).Conclusions nHAP-Mg2+ has the ability to combining and protecting DNA and can be used to transfer gene as the adjunct carrier of liposome for the gene therapy of tumor cells to elevate the gene tansfection and expression rate and also enhance the anti-tumor effection.

0.05).Conclusions Preventive transverse colostomy can not effectively reduce the incidence of AL rate following LAR,and besides the patients have preventive transverse colostomy will require reperation to close the colostomy.

Objective To investigate the value of three-dimensional visualization system in the treatment of hilar cholangiocarcinoma.Methods The clinical data of 10 patients with hilar cholangiocarcinoma who were admitted to Chenggong Hospital of Xiamen University from January 2012 to September 2012 were retrospectively analyzed.The two-dimensional computed tomography images were converted to three-dimensional images with the three-dimensional visualization system,and then the volume of liver and tumor size,volume of liver to be resected,remnant liver volume were measured.Surgical procedure was planned based on the three-dimensional images,and the difference between the actual and planned surgical procedures was analyzed.The correlation between actual liver resection volume and predicted liver resection volume was analyzed by calculating the Pearson correlation coefficient.Results The mean liver volume,tumor size,predicted liver resection volume and remnant liver volume of the 10 patients detected by the three-dimensional visualization system were (1496 ± 162) ml,(67 ± 18) ml,(335 ± 241)ml and (1140 ± 197)ml,respectively.The average error rate of predicted liver resection volume was 6.4％.Surgical plan was made in accordance with the principle of curative hepatectomy,including 4 cases of left semihepatectomy,2 cases of right semihepatectomy,3 cases of partial liver resection and 1 case of palliative liver resection.The coincidence rate between the planned and actual surgical procedures was 9/10.R0 resection was performed on 7 patients,R1 resection on 1 patient and palliative resection on 2 patients.One patient received restrictive portal vein arterialization.Preoperative evaluation of the anatomy of blood vessels,bile ducts and tumors based on three-dimensional images was confirmed with operative findings.The accuracy of tumor typing by the three-dimensional visualization system was 8/10.The actual liver resection volume was (325 ± 258) ml,which was positively correlated with the predicted liver resection volume (r =0.902,P ＜ 0.05).Conclusion The three-dimensional visualization system is helpful in the treatment of hilar cholangiocarcinoma.

Objective To explore the differences in morphology and structure of collagen fiber of the hilar bile duct between human and rat. Methods The morphology and structure of vertical and horizontal cross-section of human and rat collagen fiber of the normal and dilated hilar bile duct, and their changes under stress were observed after Masson trichrome staining. Results The morphology and structure of collagen fiber of hilar bile duet in human was similar to that in rat. The collagen fiber mainly distributed in the middle and outer layer of the hilar bile duct. The wave-like collagen fiber bundles were arranged in parallel, consistent with the longitudinal axis direction of the bile duct, and connected by the small branches. Conclusions The morphology and structure of collagen fiber of the hilar bile duct in human is similar to that in rat. The anatomical structure of the collagen fiber is adapted to its function.

Objective To investigate the effects of inhalation of different concentrations of carbon monoxide (CO) on brain death (BD)-induced lung injury in rats. Methods Thirty-two pathogen free adult male Wistar rats weighing 250-300 g were randomly divided into 4 groups ( n= 8 each): group Ⅰ sham operation (group S);group Ⅱ brain death (group BD) and group Ⅲ and Ⅳ BD + CO 0.025% and 0.050% (group C1, C2 ). The animals were anesthetized and tracheally intubated. Fogarty catheter was inserted into the skull. BD was induced by inflating the balloon slowly at 20 μl/min until apnea developed. The animals were then mechanically ventilated (VT 10 ml/kg, RR 50 bpm, PEEP 2 cm H2O) with 40% O2 in N2 . In group Ⅲ and Ⅳ CO 0.025% and 0.050%were added to the air mixture respectively. In group S the balloon was not inflated. BD was confirmed by apnea,dilated pupils and flat EEG. In group BD,C1 and C2, MAP was maintained at 80-120 mm Hg by norepinephrine infusion. The arterial blood gas analysis was performed before (baseline) and immediately after BD was confirmed (T1) and at 30, 60, 90 and 120 min (T2-5) of CO inhalation. The animals were then sacrificed. The plasma concentrations of IL-6 and TNF-α and the activity of myeloperoxidase (MPO) in the lungs were measured. The W/D lung weight ratio and lung injury score (LIS) were recorded. Results BD significantly decreased PaO2/FiO2, BE and pH while increased plasma IL-6 and TNF-α concentrations, MPO activity in the lungs, the W/D ratio and lung injury score as compared with group S. CO inhalation ameliorated the deleterious effects induced by BD. The antiinfiammatory effect of 0.050% CO was better than that of 0.025 % CO. Conclusion Inhalation of 0.025 % or 0.050% CO can ameliorate BD-induced lung injury in rats, but there is no significant difference in the efficacy.

Objective To compare and explore the differences of clinical characteristics between human adenovirus type 7 (HAdV7) and type 55 (HAdV55) infections in adults,and to provide evidences for clinical management.Methods The data of clinical manifestations,laboratory examinations,chest computed tomography and prognosis of 214 cases with HAdV7 and 235 cases with HAdV55 infections from 2012 to 2018 were retrospectively collected and analyzed.The chi-square test was used for the categorical variables,and the rank sum test was used for the continuous variables of non-normal distribution.Results Compared with patients in HAdV55,those in HAdV7 group displayed more diarrhea (12.1％ [26/214] vs 2.6％ [6/235],x2 =15.583),more laryngeal lymphatic follicles (33.2％ [71/214] vs 17.9％ [42/235],x2 =23.566),more tonsil enlargement (56.5％ [121/214] vs 20.0％ [47/235],x2 =63.870) with secretions (33.2％ [71/214] vs 11.5％ [27/235],x2 =30.878),more leukocytosis (24.8％ [53/214] vs 14.0％ [33/235],x2 =8.318),more monocytosis (78.0％ [167/214] vs 52.8％ [124/235],x2 =31.364),more thrombocytosis (7.1％ [15/212] vs 3.8％ [9/235],x2 =5.835),more elevated level of C-reactive protein (80.8％ [97/120] vs 64.3％ [137/213],x2 =10.020),more abnormalities of liver function (alamne aminotransferase [ALT]:13.5％ [28/207] vs 5.6％ [13/232],x2 =8.111) and myocardial enzymes (creatine kinase [CK]:37.6％ [77/205] vs 26.4％ [61/231],x2 =6.246),creatine kinase isoenzymes ([CK-MB]:35.6％ [73/205] vs 11.1％ [24/216],x2 =35.600),and all the differences were statistically significant (all P ＜ 0.05,0.01).Compared with patients in HAdV7 group,those in HAdV55 group displayed longer duration of diseases (7 [5]days vs 6[5] days,Z=-2.632),more sore throat (72.8％ [171/235] vs 62.1％ [133/214],x2 =0.016),more headache (62.1％ [146/235] vs 16.4％ [35/214],x2 =97.527),more pharyngeal congestion (93.6％ [220/235]vs 74.8％ [160/214],x2 =30.602),more leukopenia (14.0％ [33/235] vs 24.8％ [53/214],x2 =8.318),and more elevated level of lactate dehydrogenase (12.6％ [29/230] vs 6.3％ [13/205],x2 =4.881),more pneumonia (71.5％ [168/235] vs31.8％ [68/214],x2 =70.846) (all P＜0.05,0.01).Conclusions The clinical characteristics of HAdV7 and HAdV55 infections in adults are different.The type 55 infection is more likely to develop to pneumonia,while the type 7 infection has wider tissue tropism.

Objective:To investigate the role of chemokine receptor CX3CR1 in chronic skin inflammation and its regulatory mechanism.Methods:Wild type (WT) C57BL/6 mice and Cx3 cr1 GFP/GFP mice were induced by DNFB to establish acute and chronic allergic contact dermatitis (ACD) model. Ear inflammation and swelling were observed with hematoxylin-eosin (HE) staining. Flow cytometry (FCM) was used to detect the changes in classical Langerhans cell (LC) and monocyte-derived LC (Mo-LC), as well as the expression of major histocompatibility complex Ⅱ (MHCⅡ), inducible nitric oxide synthase (iNOS) and TNF-α. Changes in epidermal LC in UV irradiation-induced dermatitis models were also analyzed. In human chronic skin inflammation, CX3CL1 expression was detected using immunohistochemistry, RT-PCR and Western blot and CD1a, CD14 and CD207 expression was observed with immunofluorescence staining. Results:In the chronic ACD model, Cx3 cr1 GFP/GFP mice showed significantly alleviated ear inflammatory and swelling as compared with WT mice, but no significant difference was found in the acute ACD model. The percentages of Mo-LC were decreased in the chronic ACD model and after three weeks of UV irradiation. Moreover, MHCⅡ, TNF-α and iNOS expressed by Mo-LC were significantly upregulated as compared with those by classical LC. CX3CL1 expression was significantly upregulated and the numbers of CD14 + monocytes and CD1a + langerin - Mo-LC were dramatically increased in human chronic skin inflammation. Conclusions:CX3CR1 might maintain inflammatory response by regulating local remodeling of Mo-LC in chronic skin inflammation.

To compare the clinical value of superb microvascular imaging (SMI) and contrast enhanced ultrasound (CEUS) in the differential diagnosis of thyroid nodules, and to further study whether the combination of SMI and/or CEUS with thyroid imaging reporting and data system (TI-RADS) can improve the diagnostic value of TI-RADS.
 Methods: SMI, CEUS, TI-RADS, TI-RADS combined with CEUS, TI-RADS combined with SMI, TI-RADS combined with SMI and CEUS were used to differentiate thyroid nodules. TI-RADS 4b, 5 categories in two-dimensional ultrasound, hypoenhancement in CEUS, and peripheral blood flow with penetrating vessels in SMI were considered malignant signs. The diagnostic efficacy of these methods was compared according to post-operative pathology or fine needle aspiration cytology.
 Results: A total of 237 patients with 296 thyroid nodules were included in the study. The sensitivity, specificity and accuracy for TI-RADS were 78.4%, 77.7% and 78.0% respectively, 75.5%, 86.6% and 81.4% in SMI, 82.0%, 88.5% and 85.5% in CEUS, 92.1%, 90.4% and 91.2% in TI-RADS combined with SMI and CEUS. Area under the receiver operating characteristic curve (AUROC) showed no significant difference between SMI, CEUS, TI-RADS (χ2=4.29, P=0.117). AUROC of both TI-RADS combined with CEUS (χ2=39.62, P<0.001), TI-RADS combined with SMI (χ2=36.61, P<0.001) were higher than TI-RADS. AUROC of TI-RADS combined with SMI and CEUS was higher than TI-RADS combined with SMI (χ2=4.50, P=0.033) or TI-RADS combined with CEUS (χ2=4.24, P=0.039).
 Conclusion: Peripheral blood flow with penetrating vessels in SMI possesses high diagnostic value in differentiating thyroid cancer. The combination of SMI and/or CEUS with TI-RADS can be used to improve the diagnostic efficacy of TI-RADS in differential diagnosis of thyroid nodules.
Diagnosis, Differential ; Humans ; Thyroid Neoplasms ; Thyroid Nodule ; Ultrasonography