Objective To study the effect of applicaton of the implanted artificial defecation control device (IADCD) in patients with lower rectal cancer. Methods The "radical resection aiming at achieving automatically controlled defecation" was performed in 32 patients with lower rectal cancer, On the basis of Mile's operation, the IADCD was implanted in those patients. Postoperatively, the defection control, psychological effect of the defecation mode on the patients, complications and adverse effects were observed. Results In treatment group (32 cases), satisfactory defecation control was achieved in 31 cases 1 month after the operation, and in another case 2 month after operation, and no obvious complications and untoward effects. In control group(16 cases), 8 cases had 1～2 times formed stool 3 months after operation, 4 cases achieved 6 months after the operation. Conclusions For patients with lower rectal cancer, the "radical resection aiming at achieving automatically-controlled defecation" could achieve the complete resection of lower rectal tumor and near to normal defecation without obvious untoward effects.

Objective To investigate the imaging features of adrenal rest tumor.Methods Twelve patients of adrenal rest tumor proved by surgery or clinical diagnosis were retrospectively analyzed.Among these 12 patients,12 were examined with ultrasound,11 with MR and 1 with CT. MR and CT were performed without and with intravenous injection of contrast material.The imaging features of adrenal rest tumor were retrospectively summarized and the relevant literatures reviewed. Results The adrenal rest tumors were found in testis in 10 of the 12 patients,and in ovaries and broad ligament in the remaining two.The imaging features of the testicular adrenal rest tumor were summarized as following:all patients had bilateral testicular masses without change of the testicular contour. On ultrasonography,the lesions were hypoechoic, with some hyperechoic areas and appeared highly vascularized on Colour Doppler ultrasonography.The masses showed iso-density on plain CT,and avid enhancement on post-contrast CT images.The masses ranging in size from0.7 cm×1.0 cm×2.2 cm to 2.3 cm ×2.7 cm ×2.9 cm with uniform signal intensity,lobulated margin on MRI.They exhibited iso- or slight hyperintensity on T1 WI and hypointensity on T2WI relative to normal testicular parenchyma.The tumors showed intense enhancement on post-contrast MR images. No abnormality was detected with Colour Doppler uhrasonography and MR in 2 patients of adrenal rest tumor in ovaries and broad ligament. Conclusion Combining imaging features with the typical clinical history,the diagnosis of adrenal rest tumor could be suggested pre-operatively.

Endothelial leukocyte adhesion molecule -1 ( ELAM -1 ) is a member of the cell adhesion molecules,which plays a great role in the distant metastasis of tumor in ligand interactions between sLe (x)and sLe(a).Recently,it becomes a new research hotspot on applying ELAM -1 in targeted cancer therapy.Many studies results show that by regulation of ELAM -1 in biological effects ,such as ELAM-1 and ligand inhibitors , monoclonal antibody ,targeting gene ,and other mediates of the path of blocking therapy ,thereby inhibiting or bloc-king tumor distant metastasis ,so as to achieve the purpose of tumor therapy and improve the prognosis .Therefore , ELAM-1 is expected to exert a critical role in the tumor targeted therapy .In this paper ,the application value of ELAM-1 in tumor related targeted therapy is reviewed .

Objective To evaluate the diagnostic value of high frequency ultrasound in sebaceous gland carcinoma of eyelid (SC).Methods The ultrasonic characteristic for 11 cases with eyelid SC were respectively analyzed by using 13 MHz high frequency ultrasound and 22 MHz ultra-high frequency ultrasound.Results Through 13 MHz high frequency ultrasound,in 7 patients who exhibited Pagetoid invasion the lid shin thickness of tumor side displays no significant alteration in a comparison with normal side.Furthermore,the color Doppler flow imaging (CDFI) evealed a branch-like blood flow surrounding the masses in all cases,but the blood flow of seven patients with Pagetoid invasion had no difference compared with the healthy side.On 22 MHz ultra-high frequency ultrasound examination,slit-like low echo was found in 9 ;transition zone of tumor infiltration can be identified in 9 ; the echo of tumors with Pagetoid invasion was lower than the healthy side and the skin thickness of tumors with Pagetoid invasion was thicker (0.6 ±0.1) mm than the healthy side.CDFI revealed that mesh-basket like blood flow was rich in all patients,the small branch blood vessels arrived at subcutaneous,and vasa vasorum were found in some patients.The region with Pagetoid invasion was rich in blood flow.The sonography findings on 13 MHz and 22 MHz high frequency ultrasound examination were compared with chisquare test.There were significant differences on homogeneous echo,slit-like low echo,transition zone of tumor infiltration,infiltration skin thickness,blood distribution,central blood vessels,vasa vasorum,blood flow in the region with Pagetoid invasion (x2 =12.571,15.231,15.231,4.701,22.000,15.231,4.899,10.267,P＜0.05).Conclusions Slit-like low echo in the mass is a main finding of eyelid sebaceous gland cercinoma on the 22 MHz ultra-high frequency ultrasound.The ultra-high frequency ultrasound can accurately reveal the skin depth infiltrated by the eyelid sebaceous gland cercinoma and this method can provide solid guidance for clinical treatment strategies.

Objective To compare the clinical curative effect and the pros and cons of microwave intracavitary minimally invasive treatment and traditional operation for varicose veins in lower extremities.Methods(Treatment) group:The varicosities of greater saphenous vein were treated by microwave coagulation intracavitary treatment together with injection coagulation treatment of its tributaries. Control group:The varicosities of(greater) saphenous vein were treated by traditional operation.Results Treatment group was better than control group in improvement of symptoms,cosmetic effect of diseased limb,operation time,amount of blood loss,length of hospital stay,and complications of operation.Conclusions Microwave coagulation intracavitary treatment of varicose veins in lower extremities has more advantages,such as minimally invasive,little pain,quick recovery,good cosmetic effect,better result,fewer complications,and simplicity of operation.

Plasma nesfatin-1 levels were assayed by ELISA in patients with impaired glucose regulation (IGR),type 2 diabetes mellitus( T2DM ),and healthy subjects with normal glucose tolerance( control group).The results showed that plasma nesfatin-1 levels in IGR and T2DM groups were significantly higher than that in control group [ ( 1.91 ±0.79 and 1.80±0.80 vs 1.41 ±0.58) μg/L,P＜0.01 ].Plasma nesfatin-1 levels were positively correlated with body mass index(BMI),HbA1c,waist hip ratio,fasting plasma glucose,fasting insulin,and homoestasis model assessment insulin resistant index( HOMA-IR,P＜0.05 or P＜0.01 ).Multiple regression analysis showed that BMI and HOMA-IR were independent related factors in influencing plasma nesfatin-1 levels (both P＜0.01 ).These results suggest that nesfatin-1 may partially contribute to the pathogenesis of insulin resistance and T2DM.

Objective:To investigate whether pORF5 plasmid protein of Chlamydia trachomatis(Ct) induces 1L-1βand 1L-18 production in THP-1 cells,and its potential molecular mechanism.Methods:pORF5 plasmid protein was used to stimulate THP-1 cells at different concentrations(0,3,6,12,24,36 μg/ml),then the inflammatory cytokines IL-18 and IL-1βwere detected by ELISA at the time of 0,8,16,24,36 h;The mRNA expression of NALP3 inflammasome were detected by Realtime-PCR,and Caspase-1 activity was determined by Western blot analysis.THP-1 cells were transfected with siRNA targeting NALP3 and ASC gene for 24 h or pretreated with Caspase-1 inhibitor(Z-YVAD-FMK) for 30 min,and subsequently stimulated with pORF5(24 μg/ml) for 24 h,then secretion of IL-1βand IL-18 were analyzed by ELISA.Results: The pORF5 plasmid protein induced THP-1 cells to secrete IL-1βand IL-18 by dose-and time-dependent manners,production of IL-1βand IL-18 reached their peaks(491 pg/ml and 186 pg/ml) at concentration of 24 μg/ml,and the peak amount of IL-1βand IL-18 occurred at 24 h and 16 h post-stimulation respectively.pORF5 plasmid protein in-creased mRNA expression of NALP3 inflammasome and activated Caspase-1 in THP-1 cells.NALP3 siRNA,ASC siRNA and Z-YVAD-FMK reduced pORF5-induced IL-1βand IL-18 production when compared with control groups(P<0.05).Conclusion:pORF5 plasmid protein could induce THP-1 cells to produce IL-1βand IL-18 through NALP3 inflammasome activation,which may play an important role in the pathogenesis in Ct infection.

Objective To build and to apply the delayering and overall rationing system nursing mode in obstetrics with a view to provide patients with the full range and comprehensive good nursing care.Methods 2 450 patients received traditional nursing care in 2009 and 2900 patients received the delayering and overall rationing system nursing in 2010 were divided into the control group and experimental group,respectively.Reconstituting nursing practice circuit,reforming the mode of scheduling,reinforcing reliable safeguards system and establishing the model of assess performance integration were carried out in experimental group.The satisfaction rate of patients in the two groups were compared.Results The overall satisfaction of inpatients in the two group was 82.13％ and 87.26％,and the satisfaction rate in patients who had left hospital was 92.56％ and 98.82,the satisfaction of basic nursing was 84.21％ and 96.60％ and the satisfaction of health education was 90.15％ and 99.23％ all of the differences were significantly obvious( x2 was 10.32,5.96,8.85,7.81,respectively;P ＜ 0.05 ).Conclusions The application of delayering and overall rationing system nursing mode can improve the satisfaction rate of patients it is a new and efficacious road to apply excellent nursing care.

Objective To translate the English vcrsion of Intensive Care Unit Environment Stressor Questionnaire (ESQ) into Chinese,and test the reliability and validity of the Chinese version of Intensive Care Unit Environment Stressor Questionnaire (ESQ-C).Methods The ESQ-C was translated from the ESQ and back-translated,Delphi tcchnique was used to conduct cultural adaption.The reliability and validity of ESQ-C were tested in 313 cardiac surgery ICU patients.Results The ESQ-C contained 42 items.Eight factors that explained 51.803％ of the variance were extracted after exploratory factor analysis.The Cronbach's α coefficient of the questionnaire was 0.851,the odd-even split-half reliability was 0.888.Conclusion ESQ-C was proved to be valid and reliable.It's a valuablc tool to assess the environment stressors of ICU patients in China.

Objective: To analyze serum HBV-RNA levels in patients with chronic hepatitis B whose serum HBV-DNA has dropped to undetected levels after treatment with entecavir, and to explore the correlation between HBV-RNA level and liver biochemical parameters, which lay the research foundation for the clinical significance of new serological marker HBV-RNA. Methods: HBeAg negatively detected 107 cases with chronic hepatitis B whose serum HBV-DNA test results were lower than detection level for six consecutive months after receiving standard nucleoside therapy for more than 12 months were included. HBV-RNA level was detected by Perkin-Elmer reagent. HBV-DNA level was detected by Roche Cobas. Hitachi automatic biochemical analyzer was used to detect ALT and AST. Architect chemiluminescence analyzer was used to detect HBsAg, HBeAg, anti-HBe and anti-HBc. RStudio software was performed to analyze the correlation between HBV-RNA level and liver biochemical parameters. Logistic regression was used to analyze the independent factors influencing HBV-RNA level. Results: The positive detection rate of serum HBV-RNA in patients with chronic hepatitis B whose serum HBV-DNA had dropped to undetected levels after ETV treatment was 22.43%. HBsAg, ALT and AST levels in HBV-RNA positive group were slightly higher than HBV-RNA negative group, while anti-HBc levels were slightly higher in HBV-RNA negative group. There was no difference in the level of anti-HBe between the HBV-RNA negative and the positive group. Logistic regression analysis showed that anti-HBc was an independent factor influencing the level of HBV-RNA detection (P = 0.021). Conclusion HBV-RNA can be detected in some patients with chronic hepatitis B whose serum HBV-DNA level has dropped to undetected levels after ETV treatment. Serum HBV-RNA only comes from the direct transcription of cccDNA, so it is better than HBV-DNA and HBsAg to reflect cccDNA level or activity. Anti-HBc, as an independent factor influencing the level of HBV-RNA, may be used in combination as a new marker to predict the efficacy of antiviral therapy.