Objective To investigate the efficacy of laparoscopic radical resection for colorectal cancer. Methods From September 2000 to December 2004, 99 patients with colorectal cancer underwent laparoscopic radical resection (laparoscopic group) and 198 patients with colorectal cancer underwent open radical resection (open group) at the Union Hospital of Fujian Medical University. The differences in local recurrence and survival between the two groups were compared. The local recurrence of tumors and survival of patients in the two groups were calculated by the life-table method, and were compared by the Wilcoxon (Gehan) test, chi-square test and Fisher's exact test. The recurrence interval and survival time of the two groups were compared by non-parametric Wilcoxon rank sum test. Results The 2-and 3-year local recurrence rates in the laparoscopic group were both 3.0% and the overall local recurrence rate was 3.0% (3/99). The 2-and 3-year local recurrence rates in the open group were 2.6% and 4.0% , respectively, and the overall local recurrence rate was 3.5% (7/198), with no significant difference between the two groups (χ2 =0.002, P > 0. 05). The median survival time of patients with local recurrence was 15 months (range, 7-24 months) in the laparoscopic group and 11 months (range, 2-28 months) in the open group, with no significant difference between the groups (U = 15. 500, P >0. 05). The 1-year survival rate was 33.3% in the laparoscopic group and 42.9% in the open group. The 2-year survival rate was zero in the laparoscopic group and 42. 9% in the open group. There were no significant differences between the groups for the 1-and 2-year survival rates (χ2 =0.120, P>0.05). Conclusions The efficacy of laparoscopic radical resection for colorectal cancer is similar to that of open surgery. Laparoscopic radical resection for colorectal cancer is safe and feasible, and does not increase the recurrence rate of cancer.

OBJECTIVE To investigate the resistance rates of Gram negative bacilli and the distribution of ?-lactamases in hospital infections(HI) or community acquired infections(CAI) in Tongling.METHODS Antimicrobial(susceptibility)(test) was done on 356 strains of Gram negative bacilli isolated in Tongling from Oct 2003 to Sep 2004 by Kirby-Bauer method.The detection of ESBLs and AmpC ?-lactamases was performed by three-dimensional test,MBL by the double-disk synergy test.RESULTS Among total 356 strains of Gram negative bacilli,267 were with HI(53.9%) isolated from sputum of patients,89(34.8%) were(isolated) from CAI patients and urine.The antimicrobial susceptibility rates of Gram negative bacilli from CAI patients was significantly higher than that from HI patients,for Acinetobacter baumannii they were 1.5 to 3.0,for(Pseudomonas aeruginosa) were 1.2 to 1.6.No strains of Escherichia coli and Klebsiella pneumoniae were found resistant to imipenem.Among 356 Gram negative bacilli,77 strains hyperproducing ESBLs and AmpC ?-lactamases,the detection rate was 21.6%, 69 strains were isolated from HI patients,and 8 strains were from CAI patients.From strains resistant to imipenem had 13 strains detected MBL,the detection rate was 52.0%.All of them were isolated from HI patients.CONCLUSIONS The resistance of Gram negative(bacilli) is a serious problem in Tongling.The antimicrobial(susceptibility) rates of Gram negative bacilli from CAI patients are significantly higher than those from HI patients.Gram negative bacilli produce all kinds of(?-lactamases,) such as ESBLs,AmpC(?-lactamases) and MBL.

OBJECTIVE To study the resistance of Acinetobacter baumannii in our hospital and the relation with ADC ?-lactmases.METHODS Antibiotic susceptibility testing was determined by K-B methods to 115 A.baumannii strains,and three dimensional extract testing was performed to detect the ADC ?-lactmases-producing strains,blaADC gene was detected by PCR methods,and the MIC of ceftazidime,et al were determined in the presence of cloxacillin(500 mg/L) in 30 A.baumannii strains detected.RESULTS The resistance to imipenem and cefoperazone/sulbactam was below 10.4%,to other antibiotic resistance was over 54%;the multiresistance strains were 59%.ADC ?-lactmases and blaADC genes were all positive and the MIC of ceftazidime,et al except cefepime was decreased over eight-fold in the presence of cloxacillin for multiresistant A.baumannii,but not for non-multiresistant A.baumannii.CONCLUSIONS The resistance of A.baumannii is very serious in our hospital,ADC ?-lactmases-producing strains are related markedly with the multiresistance of A.baumannii.

OBJECTIVE To investigate the drug-resistant rates of clinical Acinetobacter baumannii strains isolated from our hospital and to understand the integrons distribution carried by A.baumannii.To identify the type of the integrons and analyze the correlation between integron and drug resistance in A.baumannii clinical isolates. METHODS Collected clinical isolates and the drug-sensitivity tests were completed by the method of KB.Amplified integrase were tested by PCR and identified the integron category.Correlation between integron in A.baumannii and drug resistance was analyzed.The open reading frame(ORF) of integron were amplified and observed the polymorphism of integron,Part of amplified products were sequenced. RESULTS Apart from imipenem and cefoperazone /sulbactam,the drug-resistant rate of 85 A.baumannii clinical isolates to else 15 kinds of antibacterials surpassed 30.0%.67.1% A.baumannii clinical isolates carried the integrons,and confirmed all of them belonged to integron Ⅰ after identification,but integrons Ⅱ and Ⅲ were not found.The drug-resistant rates of A.baumannii with integron to 14 kinds of antibacterials were higher than those of A.baumannii without integron.The length of amplified products in variable region of ORF of integron varied from 0.15 to 2.5 kb.The sequencing results confirmed the integron carried multidrug-resistant gene code. CONCLUSIONS Drug-resistant rate of A.baumannii clinical isolates in our hospital is higher and the majority of them are multidrug-resistant strains.The drug-resistant rates of A.baumannii with integron to 14 kinds of antibacterial are higher.The multidrug-resistant A.baumannii is associated with integrons.

OBJECTIVE To investigate the pathogenic causes of community-acquired pneumonia(CAP) in adult patients in Tongling.METHODS A prospective study was performed on 260 consecutive adult patients with CAP in Tongling city during last three years.Bacteria culture of sputum and serological tests in paired serum samples were detected.RESULTS Of 260 patients with etiological evaluation,128(49.2%) patients had an identifiable etiology,63(24.2%) had positive outcome from sputum cultured,atypical pathogens were detected from 75(28.8%)patients.Pathogens identified in 128 patients were:Mycoplasma pneumoniae(35.4%),Chlamydia pneumoniae(17.7%) and Streptococcus pneumoniae(13.6%).6.5% All patients had mixed infection.The resistance rate of S.pneumoniae to penicillin and erythromycin was 5 and 50%,respectively.CONCLUSIONS Atypical pathogens have important role in CAP,of which M.pneumoniae is the most common pathogen.S.pneumoniae and K.pneumoniae are the commonly encountered bacteria for CAP in Tongling.

Objective To investigate the antimicrobial resistance of clinical isolates in Tongling People′s Hospital during 2013. Methods A total of 2 281 nonduplicate clinical isolates were collected.Kirby-Bauer disc diffusion method was employed to study the antimicrobial susceptibility.The data were analyzed with WHONET 5.6 software according to CLSI 2012 breakpoints. Results The top 5 most frequently isolated microorganisms were E.coli (479,21.0%),K.pneumoniae (360,15.8%),A. baumannii (271,11.9%),P .aeruginosa (240,10.5%),S.aureus (171,7.5%).Gram negative and gram positive microorganisms accounted for 76.5% and 23.5%,respectively.The prevalence of methicillin-resistant strains in S.aureus (MRSA)and coagulase negative Staphylococcus (MRCNS)was 38.6% and 73.1%,respectively.The resistance rates of MR strains to beta-lactams and other antimicrobial agents were much higher than those of MS strains.No staphylococcal strain was found resistant to vancomycin or teicoplanin.E.faecalis showed relatively lower resistance to penicillin,ampicillin and nitrofurantoin.E.faecium strains were more resistant than E.faecalis to most of the antibiotics tested.Approximately 50.5% of E.coli and 44.5% of Klebsiella isolates produced extended-spectrum beta-lactamases (ESBLs).The ESBLs-respectively.And 29.8% and 23.4% of the P .aeruginosa strains were resistant to imipenem and meropenem.Nearly all (94.0%)P .aeruginosa isolates were susceptible to amikacin.Conclusions There appears a trend of increasing resistance in the clinical bacterial isolates in this hospital,especially the carbapenem-resistant Enterobacteriaceae,which is of great concern.It is mandatory to take effective antibiotic policy and infection control measures.

Objectives:To assess bowel function and quality of life in patients with ulcerative colitis (UC)after ileal pouch anal anastomosis (IPAA).Methods:Clinical data of 37 UC patients after IPAA between 2014 and 2017 were retrospectively analyzed at Sir Run Run Shaw Hospital School of Medicine Zhejiang University. The IBDQ and Bowel Function questionnaire were used for analyzing correlation between clinical variables and quality of life or bowel function.Results:Laparoscopic operation was performed in 12 cases at stage 2 and 25 cases at stage 3. Postoperative defecation of stage 3 patients were better than that of stage 2 ( t=6.72, P<0.05). The number of daily defecation in age >45-year-old group was more than that in <45-year-old ( t=3.49, P<0.05), and the rate of evening stool seepage in the older group was higher than in the younger group( t=5.28, P<0.05). The total score of intestinal symptoms of IBDQ in patients of pouchitis was lower than that without pouchitis ( r=0.330, P<0.05). The total score in age >45 in terms of systemic symptoms ( r=0.349, P<0.05) and emotional function ( r=0.379, P<0.05) was higher than age <45. Conclusions:Outcomes of UC patients after IPAA are satisfactory, bowel function and quality of life is related with age, and stage of IPAA affect postoperative defecation.

Objective To investigate the possibility,surgical methods,outcome and surgical indications of minimal invasion dynamic hip plate (MIDHP) through percutaneous limited open reduction in treatment of subtrochanteric femur fractures.Methods All cases underwent percutaneous limited open reduction with MIDHP.Duration of operation,intraoperative bleeding volume,length of incision,incidence of intra-or post-operative complications of all case were recorded.X-ray films were reviewed periodically after operation to analyze aspects of fracture displacement,loosening of intemal fixation,screw cutting femoral neck,screw penetrating out of or withdrawing from femoral head,bending or breaking of internal fixation,and fracture healing.Hip joint function was evaluated according to Huang' s criteria.Results Operation lasted for 45-55 minutes (average 50 minutes),showing the incision length of 4.0-5.0 cm (average 4.5 cm) and blood loss of 50-200 ml (average 150 ml).A total of 21 cases were enrolled in the study and were followed up for 6-28 months (average 18 months).In the follow-up,loosening or bending of internal fixation,fracture displacement,screw cut-out,and screw penetrating or withdrawing from femoral head did not occur.In the meantime,incision,bone,and joint were not infected.All cases had bony fusion within 3 months with the fracture healing rate of 100％.According to Huang' s criteria,hip function was excellent in 19 cases and good in two.Conclusions MIDHP with percutaneous limited open reduction is characterized by less trauma,small incision,less blood loss,less postoperative complications,firm fixation,early functional exercise,free load,and good hip functional recovery and hence is suitable for cases of different subtrochanteric femur fractures,especially for cases combined with osteoporosis.

Objective To perform a mechanical test of fresh cadaver specimens and compare the biomechanical properties of the novel minimal invasion dynamic hip plate (MIDHP) and the dynamic condylar screw (DCS) in treatment of subtrochanteric fractures of the femur.Methods All specimens were firstly used to simulate models of Seinsheimer type ⅡA subtrochanteric fractures of the femur,which were later divided into DCS group and MIDHP group.Based on experimental requirements,the femoral head and distal femur were embedded using seff-freezing type dental base acrylic resin powder.Torsion strength test was given in the first place,succeeded by compression strength test.Finally,destructive test was made to record the limit load.All experimental data were analyzed statistically.Results Torsion strength test showed that specimens of both groups were basically stable as the reverse was within 3°.Torque for specimens in DCS and MIDHP groups was (3.16 ± 0.13) N · m and (3.31 ± 0.27) N · m respectively as the reverse was 1.5°.Both torque and torsion stiffness had no statistical significance between the two groups,and the anti-rotation features of the two internal fixations were similar.Compression strength test showed that compression stiffness of specimens in DCS group was (532.27 ±61.02) N/mm and (581.98 ±77.56) N/mm in MIDHP group at a load of 800 N,with evidently higher compression displacement and stiffness in MIDHP group (P ＜ 0.05).Destructive test showed the maximum load of specimens in DCS and MIDHP groups was (2 994.38 ±244.81) N and (3 322.13 ± 141.21) N respectively,far higher in MIDHP group (P ＜ 0.01).Conclusions MIDHP is characterized by reasonable design,strong anti-rotation property and anti-compression property over DCS.In comparison with DCS,MIDHP has biomechanical advantage in treatment of femoral subtrochanteric fractures,for it can be performed minimally invasive and is worthy of further application.

Objective To investigate the value of low-dose coronary artery imaging with flash dual-energy CT.Methods In total of 240 patients suspected with coronary heart disease were performed dual-energy CCTA(DE-CCTA)and were divided into four groups according to the A tube electric current and the methods of reconstruction,including group A(conventional group:180 mAs+FBP)and low-dose groups(including group B,C,D:1 50 mAs,120 mAs,90 mAs +SAFIRE,respectively).The mean of CT value, image noise,SNR,CNR,image quality and radiation dosage were compared among the four groups.Among the patients,52 cases with coronary artery stenosis which were diagnosised by DE-CCTA were also confirmed by CAG,and the consistency of these two methods in the diagnosis of coronary artery stenosis were compared.Results The scores of all image quality were more than 3 points and were statistically significant among the four groups(P <0.05).The mean of CT value is not statistically significant (P >0.05), while the image noise,SNR,CNR and the radiation dosage were statistically significant (P <0.05)among the four groups.The ED of group D was lower 55.62% than group A.DE-CCTA and CAG in the diagnosis of coronary artery stenosis had satisfactory consistency (Kappa=0.84,P<0.05).Conclusion Low-dose coronary artery DE-CCTA not only have none affect of image quality and diagnostic accuracy, but also can significantly reduce the radiation dosage.