Objective To evaluate the clinical value of anastomate in treatment of rectal lesion. Methods The anastomate was used to resect space occupying lesion which was 5~12cm from anal.Then thwe operation procedure,operation time, recurrence complications and correlated problems were summarized.Results The average operation time was 34 minutes. Exceot for one case of anastomtic bleeding and one case of recurrence 14 months post operation.there were No other complications.Conclusions Stapling-resecting the rectal lesion was feasible,but some problems were solved from the design of anastomate.

Apoptosis and autophagy are common life phenomenon in various cells, which widely involve in physiological and path-ological processes, and interact with one another by many factors and multiple pathways. This intricate relationship runs through a vari-ety of cardiovascular diseases, and plays an important role in the occurrence, development and prognosis of many cardiovascular disea-ses. The effects of apoptosis and autophagy and their interrelationship in cardiovascular diseases were reviewed and summarized in this paper.

Objective:To analyze the correlation of single nucleotide polymorphisms ( SNP) of ATP binding cassette transporter A1 gene (ABCA1) and lower extremity atherosclerotic disease (LEAD). Methods: The clinical data and peripheral blood were col-lected from 630 participants (314 LEAD cases and 316 normal controls) in Han population of Minnan. The 9 SNP genotypes in the ABCA1 gene were detected by Sequenom MassArray. Results:Among the 9 SNP genotypes, rs2980083 was rejected because it wasn' t in accordance with Hardy-Weinberg equilibrium. Obvious linkage disequilibrium was found between rs2066714 and rs2066715, rs1800976 and rs2246293, rs2246293 and rs2980083, and rs1800976 and rs2980083(D′>0. 9,r2 >1/3). There were no significant differences (P>0. 05) in 6 haplotypes of ABCA1 gene groups between the LEAD cases and the normal controls. No significant differ-ences (P>0. 05) were found in frequency distribution between the LEAD cases and the normal controls in 8 SNP according to the re-sults of genotype statistics. There was no onset risk of LEAD according to the gene logistic regression analysis. Conclusion:The SNPs of rs10124755, rs2980083, rs1800976, rs4149341, rs2066714, rs2066715, rs2066716, rs2230808 and rs2246293 might not correlate with the susceptibility of LEAD in Han population of Minnan.

BACKGROUND: Both Allergic rhinitis and bronchial asthma are allergic diseases of respiratory tract. They frequently coexist in the same patients.OBJECTIVE: To study the incidence of allergic rhinitis in patients with bronchial asthma in Nanjing, and to analyze the correlation of clinical characteristic between allergic rhinitis and bronchial asthma.DESIGN: The questionnaire survey.SETTING: Department of Otorhinolaryngology-Head and Neck Surgery and Department of Respiratory, Nanjing General Hospital of Nanjing Military Area Command of Chinese PLA.PARTICIPANTS: A total of 134 patients with bronchial asthma including 73 males and 61 females were selected form Nanjing General Hospital of Nanjing Military Area Command of Chinese PLA from February 2001 to April 2005. Their ages ranged from 3 to 72 years. Severity of asthma of all patients was classified based on Global Initiative for Asthma (GINA). The diagnostic criteria of allergic rhinitis were established referred to the guideline of Haikou Meeting (November, 1997). All patients provided the confirmed consent.METHODS: The questionnaire survey of 134 bronchial asthma patients from the city of Nanjing was conducted. Their age, classification, severity, treatment status, and the family history of all 134 patients were investigated in details. Differences of age, age at onset, and course of disease between rhinitis and asthma of all patients were examined by two independent t tests. The correlation between clinical characteristics of allergic rhinitis and bronchial asthma was analyzed by Spearman rank correlation.MAIN OUTCOME MEASURES : Incidence of allergic rhinitis in patients with bronchial asthma and the correlation of clinical characteristic between allergic rhinitis and bronchial asthma.RESULTS：Of all 134 bronchial asthma patients，82(61．2％,82/134)were accompanied with allergic rhinitis．There were 45 males and 37 females．Of 82 patients with allergic rhinitis accompanying with bronchial asthma，severity was classified into grade Ⅰ (mild pause,n=56)，grade Ⅱ (mild persistence，n=21)，grade Ⅲ (moderate persistence，n=4)，and grade Ⅳ (severe persistence，n=1)．In addition,allergic rhinitis was classified into periodicity (n=65) and persistence(n=17)．According to the classification and seventy system recommended in ARIA,63 patients had mild symptoms and 19 had moderate and severe symptoms．Severity of allergic rhinitis was positively related to that of bronchial asthma(r=0.689,P＜0．01)．CONCLUSION: The morbidity of allergic rhinitis combining with bronchial asthma is high in Nanjing, China. While, their classification and severity are highly coherent.

Objective To analyze the risk factors for the outcomes of recipients after orthotopic liver transplantation using donation after cardiac death (DCD) donors.Method A retrospective study was performed to observe the available clinical data of 60 patients who had receiced hepatic allografts of DCD donors from July 2007 to December 2012 in our hospital and a 3-year follow-up was conducted to investigate outcome.In the patients whose ALT and/or AST levels were more than 1500 U/L within 72 h following surgery,early allograft dysfunction (EAD) was defined.Potential risk fators right before surgery included donor and recipient age,donor ALT AST,TBIL and WIT,and recipient creatine,TBIL,INR,albumin,MELD,BMI and recipient CIT.Kaplan-meier method was used to calculate the cumulative survival rate.Log-rank test and Cox regression model were performed to analyze donors and recipients related risk factors by univariate and multivariate analysis respectively.All statistical data were analyzed by using SPSS 19.0.Results The overall cumulative survival rate of 1 and 3 years was 76％ and 62％ respectively.Donor ALT,AST and WIT,and recipient Cre,MELD,CIT and EAD were significant risk fators in univariate analysis.However,the multivariate analysis revealed that donor WIT was the only independent risk factor affecting survival in our study.Conclusion By identifying and controlling certain characteristics,the outcomes of DCD liver transplant recipients could be dramaticly improved.

Objective To observe the clinical efficacy of HMME-SDT therapy for the treatment of hypertrophic scar (HS) of rabbit ear.Methods 60 white rabbits were randomly divided into five groups.The model group and HMME-SDT treatment group were used to establish the models of hypertrophic scar in ears.Results The effect of HMME-SDT on the fibroblastic density in the hypertrophic scarring models was observed in rabbit ears.The HMME-SDT could lower the fibroblastic density,compared with the model group,with significant difference (P＜ 0.05).The effect of HMME-SDT on the collagen area density was noted in the hypertrophic scarring models in rabbit ears.The HMME-SDT could lower the collagen area density,compared with the model group,with significant difference from the fourth week of the epithelialization (P＜0.01).Conclusions HMME is an effective sonosensitizer.HMME-SDT can significantly inhibit hypertrophic scar of rabbit ear.

Objective To observe the morphological changes of rats' pancreas and nitric oxide (NO) and endothelin(ET) in the blood serum in rats after exposure to different pulses of high power pulse microwave (HPPMW).Methods SD-rats were irradiated with 104,105 and 4 × 105 pulses of HPPMW,respectively.After gloss observation,the histopathological changes of pancreas were observed through biological microscope and electroscope.The changes of amylase,nitric oxide and endothelin in blood serum were detected by biochemical and radio-immunological methods. Results Compared with the blank control,no apparent abnormality could be observed in the pancreas of all groups.The dilatation of capillary could be observed in each experimental group by microscope.The ultrastructure changes of pancreas were most serious in 4 × 105 pulse group,especially at 24 and 48 h after irradiation.Compared with the control group,the levels of serum amylase were decreased (F =12.58,11.73,P ＜ 0.05),while ET were increased (F =4.50,4.49,P ＜0.05) at 24 and 48 h after irradiation.The levels of NO in serum were increased ( F =17.51,41.72,19.98,32.64,P ＜ 0.05 ) at each time-point.The level of NO went up with the increase of pulses.Conclusions HPPMW has damage effects on the pancreas in rats.The pulses with the pancreas can lead to severity of the damage. The mechanism of HPPMW may be involved in the enhancement of ET and NO in serum.

Objective To assess the efficacy of stone fragmentation and clearance of this new intracorporeal ultrasound lithotripter (CQS-01) compared with currently available ultrasound units (EMS-Ⅲ/Ⅳ).Methods Twenty phantom stones composed of dental gypsum were randomly divided into four groups,and CQS-01 ultrasound lithotripter (70％ power and 70％ duty factor),EMS-Ⅲ ultrasound lithotripter (70％ power and 70％ duty factor),EMS-Ⅳ ultrasound lithotripter (type A,70％ power and 70％ duty factor) and EMS-Ⅳ ultrasound lithotripter (type B,70％ power and 100％ duty factor) were used to fragment and removepbantom stones.The mean stone breakdown time and fragment removal time and stone fragmental sizes for the standard ultrasound devices were compared to determine the completeness and efficiency of stone fragmentation and removal.Results The average time for stone breakdown was 7.4 ± 1.9 s,9.4 ± 1.6 s,82.2 ± 12.6 s and 51.4 ± 18.7 s,respectively.There was no significant difference between CQS-01 and EMS-Ⅲ (P ＞ 0.05),but there was significant difference between CQS-01 and EMS-Ⅳ (A or B) (P ＜ 0.001).The average time for stone clearance using the ultrasound devices was 387.8 ± 68.0 s,41 1.6 ± 57.6 s,568.0 ± 119.1 s and 383.6 ± 75.6 s,respectively.In addition,the average size of the largest fragments removed was the same among the groups (＜ 3 mm).Conclusion The ultrasound capabilities in a newly developed lithotriter (CQS-01) exhibited the same ability to fragment and clear phantom stones compared with standard ultrasound devices.

Objective To compare the surgical and functional outcomes of single-site (transumbilical two-port) intracorporeal purse-suturing (IP) and single-port extracorporeal knotting (EK) for laparoscopic pediatric inguinal hernia (PIH) repair.Methods Between June 2008 and December 2014,358 PIH children underwent lapamscopic inguinal herniorrhaphy,including 126 treated by single-site intracorporeal purse string stitching using a needle-holder (IP group),and 232 by single-port extracorporeal knotting using an inner two-hook needle with preperitoneal hydrodissection (EK group).Results In all patients laparoscopic procedures were completed successfully without conversion.The operating time in IP group was significantly longer than that in EK group [unilateral:(20.4 ± 2.1) min vs.(9.4 ± 1.3) min,t=-5.23,P＜0.01;bilateral:(31.3 ±2.9) min vs.(15.2±1.7) min,t=-4.22,P＜0.01)].The hospital stay were similar between the two groups [(2.35 ±0.25) d vs.(2.38 ±0.18) d,t =-0.062,P ＞ 0.05].Five cases had intraoperative hematoma in the IP group while none in the EK group.One each suffered from recurrence in IP group and EK group.Three postoperative hydroceles were seen in IP group and one in EK group.Subcutaneous knot granulomas were seen in two in EK group.Conclusions Both IP and EK laparoscopic procedures are safe and feasible.With the assistance of preperitoneal hydrodissection technique,single-port laparoscopic EK herniorraphy is superior to single-site IP repair in easy performance and shorter operation time.

The clinical data were collected from medical record of 749 patients admitted into Peking Union Medical College Hospital from January 2008 to March 2013.They were diagnosed with primary Sj(o)gren's syndrome (PSS) at discharge.Clinical manifestations,laboratory results and outcomes were compared between PSS patients with pulmonary hypertension (PSS-PH) and those without (PSS-non PH).PSS-PH group had higher proportions of Renault phenomenon (36.8％ vs.20.0％,P =0.05),pericardial effusion (55.3％ vs.0.0％,P＜0.01),leukocytopenia (42.1％ vs.30.0％,P =0.03),elevated IgG level [(28.8 ±11.2) vs.(21.5 ±10.0) g/L,P=0.01] and hypothyroidism(34.2％ vs.12.5％,P=0.05) with significant significance.The PSS patients had leukocytopenia low thyroid function,rising IgG and pericardial effusion with pulmonary hypertension.