Objective To evaluate the advantage of laparoscopic total mesorectal excision (TME) and the clinical value of pull-through anastomosis in the treatment of rectal carcinoma. Methods From November 2005 to December 2006, laparoscopic TME combined with pull-through anastomosis was carried out on 8 patients with rectal cancer. Results In all of the 8 patients, TME was completed under a laparoscope without additional incision, and the pull-through anastomosis was performed by hand.The mean operation time was 220 minutes (range, 180 to 300). The patients were followed up for 8-18 months (mean, 13 months), during which none of them developed implantation at puncture sites or local recurrence. Conclusions Laparoscopy provides a direct, magnified and reliable view for TME. Pull-though anastomosis is a convenient and low-cost method.

Objective To observe the morphological characteristics of oval cells in human chronic liver diseases, and determine whether there is a relationship between the number of oval cells and liver fibrotic stage. Methods Oval cells were detected in paraffin bedded liver sections of 3 normal subjects (as controls) and 29 chronic liver diseases, using histoimmunochemistry. Cells were counted if they fulfiled the morphological criteria for oval cells and showed cytoplasmic staining. Results Oval cells were not observed in normal livers. In chronic liver diseases, oval cells were located predominantly in the periportal region and fibrosis septa, characterized by an ovoid nucleus, small size, and scant cytoplasmic. The number of oval cells increased significantly ( F=22.60, P

Objective To study the morphological appearance and pathological basis of the fine pulmonary reticulation at HRCT.Methods One hundred and seven patients were analyzed about the morphology findings and dynamic changes on pulmonary HRCT.Twenty-four coal worker's pneumoconiosis(CWP)specimens were examined to make comparison between CT and pathology.The data was analyzed by using the Chi-square test.Results The reticular gap was less than 3 mm in diameter.The morphology of reticulation was round or irregular.Pulmonary parenchyma was seen between the gaps.The reticular wall was smooth or coarse.The thickness was less than 1 mm.One hundred and seven patients had accompanying signs including ground-glass opacity(68.2%,73 patients),crazy paving(23.4%,25 patients),interlobular septal thickening(84.1%,90 patients),emphysema(32.7%,35 patients),interface sign(58.9%,63 patients),traction bronchiolectasis(41.1%,44 patients)and honeycombing(26.2%,28 patients).The differences of the honeycomb,traction bronchiolectosis,interbobular septal thickening,interface sign and paving were statistically significant between the fibrotic group and pneunonia(P＜0.01).Pneumonia showed extensive area of ground-glass opacity(GGO)with fine reticulation.Fine reticulation with both interlobular septal thickening and small nodules were observed more frequently in lmphangitic carcinomatosis.Idiopathic pulmonary fibrosis(IPF)showed fine reticulation among the honeycombing.Connective tissue disease (CTD)showed fine reticulation with rarely honeycombing and it could be partly absorbed.Fine reticulation with emphysema was seen in chronic bronchitis.In the 58 follow-up patients,the fine reticulation increased in 26 patients,decreased or disappeared in 22 patients and showed no change in 10 patients.The major pathological basis of the fine reticulation was intralobular interstitial thickening,including fibrosis hyperplasia,inflammatory cells and tumor cells infiltration,effusion filling,smut deposition and so on.Conclusions The fine reticulation was caused by intralobular interstitial thickening including inflammation,interstitial hyperplasia,pulmonary fibrosis and tumor.The fine reticulation is helpful to prompt the diagnosis of these diseases,but the diagnosis need its combination with the other CT findings and dynamic changes.

Objective To sequence and analyze the full-length genome of one HEV strain,W2-1 isolated from a sporadic hepatitis E patient hospitalized in 1999 in Xinjiang,China.Methods Nested RT-PCR assays with 4 sets primers were used to amplify the entire genome.The PCR products were purified and sequenced.The full-length genome was acquired by assembling the fragmental sequences using the DNAstar 5.01 software.The genome of W2-1 was analyzed by comparing with the reference HEVs from GenBank.Results The complete genome of W2-1 is 7212 nt in length,including three open reading frames (ORF1-3) with 5079,1980 and 345 nt respectively,27 nt 5'UTR and 83 nt 3'UTR,and a 3' poly A tail.Phylogenetic analysis based on full-length genome showed that W2-1 belonged to genotype 1,subtype 1b.W2-1 had high homology with the HEV strains isolated in the large hepatitis E epidemic in Xinjiang in 1987-1989,sharing 97.2％-98.5％ nucleotide identity in the full length genome.W2-1 also showed high homology with 1b strains isolated in China after 2000,with 97.6％-99.2％ nucleotide identity.The specific amino acid sites in ORF1-3 proteins that distinct between genotype 1 HEV and the potential zoonotic strains did not change in W2-1.Conclusion W2-1 belongs to subtype 1b.The study indicates subtype 1b HEV has been circulating in China in a long period after hepatitis E outbreak in Xinjiang in 1986-1989.The amino acids of ORF1-3 of subtype 1b are conserved.

Objective To investigate the role of apoptosis in hepatocyte injury in tyep Ⅰ autoimmune hepatitis (AIH). Methods Using transferase mediated UTP biotin nick end labling (TUNEL) technique and immunohistochemistry with anti Fas antibody, we detected apoptosis cells in 10 liver biopsy samples and 3 control livers obtained from normal subjects. Result Hepatocytes in all AIH liver tissues were positively stained by TUNEL and anti Fas antibody in various degree. In contrast, control tissues did not show DNA fragmentation or positive stain with anti Fas antibody. A significant correlation was seen between apoptosis index (AI) and necroinflammatory grading ( r =0.45, P

In recent years,the quality of study of medical students in their internship has declined because of the interruption of graduation record examination and obtaining employment after graduation.We made many managments every year in administration to enhance rules;On one hand we changed teaching pattern,methods and take a series of stimulating measures to encourage and promote teacher's teaching consciousness,on the other hand we ensured the quality of internship study and cultured excellent qualified medical students by adjusting time of internship,keeping a strict hand over examination and so on.

Unified examination refers to the examination given by the university for medical students to graduate after they pass six curriculum examinations,including diagnostics,introduce of surgery,internal medicine,surgery,obstetrics and gynecology and pedology during the clinical study phases.It is a necessary process for cultivation of the professionals of the clinic medicine and has practice significance.Through the organization and management of the unified examination process,as well as analysis of examination result and feedback,education quality has been enhanced and educational reform promoted.

Objective To elucidate the CT characteristics and pathology of acute miliary pulmonary tuberculosis (AMPT). Methods The CT features of AMPT in 25 cases were analyzed retrospectively, and the CT features in HIV-seronegative and HIV-seropositive patients were compared by 2-sided exact propability Chi-square test. Two lung specimens were inflated and fixed by Heitzman's method. HRCT scans, gross specimen section (80-150 μm) and histologic section (5 μm) were performed on dry lung specimens and CT-pathologic correlation was conducted. The distribution of micronodules in the secondary lobule on HRCT and pathology in one specimen was evaluated by Chi-square test. Results Twenty five patients with AMPT were included in this study, including 11 HIV-seropositive patients and 14 HIV-seronegative patients. HRCT showed diffuse micronodules randomly distributed throughout both lungs in 25 patients, and ground-glass opacity (17 patients)was the predominant complicated finding. Coalescence of nodules and consolidation in HIV-seropositive patients (5 and 6 patients) were markedly higher than that in HIV-seronegative patients (none). In lung specimens, most nodules located in the lung parenchyma between the central bronchovascular bundle and the perilobular structures (792 and 560 nodules), which located in the interlobular septum pathologically. The distribution of micronodules in the secondary lobule showed on HRCT (1060 nodules)and pathology(864 nodules) was not significantly difference(x2=2.814,P＞0.05). HRCT showed ground-glass opacities when ARDS occured, which were pulmonary edema,inflammation and hyaline membrane on alveolar wall pathologically. Conclusions The HRCT characteristic of nodule distribution in AMPT is random. ARDS should be suspected when diffuse ground-glass opacities appear on HRCT.

Objective: To observe the pathological changes of the lens and anterior lens capsule of the patients with familial congenital aniridia, and discuss the histopathological etiology of the fragility of the anterior capsule and the significance of surgical project. Methods: Anterior lens capsules and lens specimens were obtained from aniridic patients during cataract surgery. The intraoperative behavior of each capsule was noted, after which the specimens were submitted for histopathologic evaluation and electron microscope examination. Results: The anterior lens capsule was extremely fragile and remarkably thin. Degenerative changes(degeneration, necrosis, loss) of the lens epithelium and discontinuity of the lens epithelium were found in some specimens. Proliferation and double layer of the epithelial cells in some area of the specimens can be seen also. Ply structure of the anterior capsule became thin or disappeared. Conclusion: Degenerative or proliferative changes of the lens epithelial cells were associated with the thinness and extreme intraperative fragility of the anterior lens capsules in familial aniridia with cataract. Greater awareness of anterior capsule fragility in some aniridic patients with cataract may reduce the risk of capsule complications and lead to safer surgical outcomes.

Objective To establish a Chinese hamster model of babesia infection, to find the changing pattern of organs and biochemical parameters in Chinese hamster infected with Babesia, and to promote the detection and treatment of babesiosis.Methods Healthy 5-week old Chinese hamsters were infected by intraperitoneal injection of blood containing Babesia.Blood samples were collected at 0, 2, 4, 6, 8, 10, 12, 14, 16, 23, 30, and 37 days after infection from 5 hamsters at each time point.Blood smears were prepared to detect the parasites using Giemsa staining.ELISA assay was employed to test the IL-2 concentration.The blood biochemical indexes were detected using an automatic biochemical analyzer.DNA was extracted from the whole blood and REAL-TIME RCR was performed to determine the reproduction of Babesia.Aftert the animals were sacrificed, the heart, lung, spleen, liver, and kidney were taken to analyze the changes of organ coefficients.Results The highest level of Babesia in the hamsters occurred on day 4 after the Babesia injection, and then showing a decreasing tendency.However, there was a transient increase on the 12th day after infection.The liver and spleen displayed most extensive response to the infection showing hepatomegaly and splenomegaly, but the variation of heart and kidneys coefficients was within the norm.There were prominent changes of blood cells, especially leucocytes, with two peaks at day 10 and 23 after the Babesia infection.The peak changes of blood biochemical indexes occurred at day 12 after infection.The concentration of serum IL-2 reached a peak on the 10th day after infection.Conclusions The Chinese hamsters display typical characteristics of tick-borne diseases such as hepatomegaly and splenomegaly.The immunological system is activated along with the infection and reaches a highest stage in the second week.Afterwards the Babesia can live in the hamster body for a long period of time.The results of this study provide useful information supporting further studies on the detection, treatment and prevention of Babesiosis.