Objective To evaluate outcome of local excision of rectal cancer for curative purpose.Methods Fifty four patients with low rectal carcinoma undergoing local excision from 1975 to 2000 were analyzed retrospectively.Results In this study, 44 patients underwent trans anal resection (TAR), 6 did trans sacral resection (TSR), 2 each did trans sphincteric local resection (TSLR) and trans vaginal resection (TVR). Most tumors were within 8 cm from the anal verge, and the average distance was 6 6 cm in TSR, 5 2 cm in TVR, 4 7 cm in TAR and 4 5 cm in TSLR, respectively. Most tumors (89%, 48/54) were less than 3 cm in diameter, six tumors (11%) were larger than 3 cm. The mean size of tumor was 3 5 cm in TSR group, 3 5 cm in TSLR, 2 5 cm in TAR, and 2 5 cm in TVR. Tumors were in T 1 stage in 46 patients and in T 2 in 8 patients. Postoperative complications included anastomosis leakage in one, sphincteric dysfunction in 2, and anal bleeding in 2. Eight patients (15 1%) recurred locally during the period of postoperative follow up, at a mean time of 42 2 months ranging 10 to 84 months. Five, ten year overall survival rates were 86 7% (39/45) and 69 2% (27/39)for T 1 tumor, and 75 0% (6/8) and 33 3% (2/6) for T 2 tumor, respectively.Conclusions Local excision of rectal cancer is of less injury and early recovery in properly selected patients while not at the expense of long term survival.

BACKGROUND:The comfortable shoes can absorb or reduce the impact force from the ground. Is the damped system is absent in shoes to relieve the impulse,the feet will be extremely tired,even damage the human knee joint,waist,back and brain. OBJECTIVE:To measure the changes of human plantar pressure by different sole hardness through the measurement system of plantar pressure. DESIGN,TIME AND SETTING:An observation experiment was performed in the Shanghai University of Sport between December 2008 and February 2009.PARTICIPANTS:Six volunteers wearing the experimental designed shoes were recruited from Nanjing Institute of Physical Education.METHODS:Three pairs of experimental shoes weighing 103 g were measured with shore hardness tester,as 51,62 and 69 hardness values. Accordingly they were named soft shoes,medium hardness shoes and hard shoes. The subjects were asked to do a 60-minute walk test at the speed of 2 m/s on the running platform with the experimental designed shoes,and they were determined using the insole plantar pressure measurement system of German's Novel style series of Emed-pedar.MAIN OUTCOME MEASURE:The pressure,contact area and impulse in the sole of foot.RESULTS:With the increase in hardness soles,the pressure of center plantar was shown to move from the medial first metatarsal outwards by turns. Compared with barefoot walking,the trail length of the center plantar was prolonged in subjects with medium hardness shoes and hard shoes,while shortened in subjects with soft shoes. The total pressure when you walked with soft shoes and medium hardness shoes were reduced than barefoot walking,and the pressure of walking phase wearing these two types of shoes were also reduced,while total pressure and walking phase pressure with hard shoes were both increased compared with barefoot walking. The contact area was similar between soft shoes and medium hardness shoes,but the smallest in the hard shoes. Except the increase in the initial 10 minutes,the soft shoes had no change with the medium hardness shoes. The hard shoes were firstly increased but then declined. The total impulse of medium hardness shoes was the closest to bare feet,while that of soft shoes and hard shoes were increased compared with bare foot.CONCLUSION:The plantar pressure was the greatest in the hard shoes,then medium hardness shoes and last soft shoes;the contact area was the greatest in soft shoes,then medium hardness shoes and last hard shoes;the impulse was the greatest in hard shoes,then soft shoes,and last medium hardness shoes.

This study was aimed to observe effects of different doses of D-galactosamine (D-GalN) plus lipopoly-saccharide (LPS) and blood coagulation changes among rat model of acute liver failure, in order to establish an ideal model of acute liver failure in rats. SD rats were randomly divided into the control group, D-GalN high, medium and low dose groups, with 10 rats in each group. Except the normal group, rats in other groups were injected with D-GalN plus LPS at different doses to induce acute liver failure. The mortality of rats was observed. The liver function and blood coagulation were detected from rat serum at 0 h, 12 h, 24 h, 48 h, and 72 h. HE stain was used in the observa-tion of changes on liver pathological changes. The results showed that the mortality of D-GalN high, medium and low dose groups within 72 h were 60%, 30%, 10%, respectively. There were significant differences on the serum content level of ALT, AST, TBIL, PT, INR, FIB from different dose groups at different time points and the normal group (P<0.05). However, the comparison among D-GalN high, medium and low dose groups showed no statistical difference on ALT and AST; while there were statistical differences on TBIL, PT, INR and FIB (P < 0.05). It was concluded that coagulation index was more stable in the liver failure model. Through observation on the liver function, blood coagulation and pathological morphology, the model of acute liver failure induced with medium dose of D-GalN plus LPS in SD rats at 48 h was more similar to the clinical symptom of acute liver failure. Therefore, the medium dose was the ideal model inducing dose.

Objective: To study the effect of bifidobacterium-supplemented enteral nutrition in early postoperative patients with gastric cancer. Methods: 60 patients with gastric cancer were divided into two groups: bifidobacterium-supplemented enteral nutrition(BSEN-group, 30 cases), popular enteral nutrition group(EN-group,30 cases). The patients were infused with Nutrison Fibre or bifidobacterium-supplemented Nutrison Fibre for 7 postoperative days. Results: Bifidobacterium-supplemented enteral nutrient was well tolerated. The incidence of infections was significantly lower (P = 0.01) in BSEN-group than in EN-group. Conclusion: Early postoperative enteral nutrition plus bifidobacterium can reduce the rate of postoperative infections in comparison with popular enteral nutrition.

Objective: To investigate the expression of HSP-27,-60 and -90 in gastric cancer and its clinical significance. Methods:66 cases of gastric carcinoma was detected by immunohistochemistry HSP-27,60 and 90 of the expression and clinical significance of combined with clinical and pathological characteristics, tumor cell proliferation and survival analysis of three kinds of heat shock protein expression. Results: HSP-27,-60 and -90 were highly expressed in gastric cancer tissues. HSP-27 expression and tumor size (pT,P=0. 026),organ metastasis (pM,P=0. 046) and pathological staging (P=0. 041),HSP-27 staining intensity and lymph node status were significantly correlated ( pN, P=0. 042 ) . HSP-60 expression was associated with gender ( P=0. 011),and HSP-60 staining intensity was associated with age (P=0. 027) and tumor grade (P=0. 031). There was no correlation between HSP-90 expression and the clinical pathological parameters of this study; however, the intensity of HSP-90 staining was significantly correlated with tumor size (P=0. 020,pT). Single factor analysis showed that HSP-90 was significantly associated with longer survival (P=0. 033). Multivariate analysis demonstrated that HSP-90 was highly expressed as an independent prognostic factor for gastric cancer (P=0. 026). Conclusion: the HSP-27,-60 and -90 and some clinical pathological parameters. These parameters is very important for the treatment of patients with gastric cancer. The high expression of HSP-90 in patients with gastric cancer were inde-pendent prognostic indicators.

Objective To analyse the effect of irinotecan hydrochloride injection on serum glutathione peroxidase 3 (GPX3), and WNT1 induced signaling pathway protein 2 (WISP2) and fibroblast growth factor binding protein 1 (FGFBP1) in tumor tissue fluid of patients with advanced rectal cancer.Methods 90 patients who were diagnosed with advanced rectal cancer in the hospital were collected.All patients were randomly divided into experimental group and control group,control group were treated with oxaliplatin +calcium folinate +fluorouracil chemotherapy, and experimental group were treated with oxaliplatin +calcium folinate +irinotecan hydrochloride injection chemotherapy.The treatment were repeated every four weeks, a total of six times.The serum GPX3 content, and WISP2, FGFBP1 levels in tumor tissue fluid were detected in two groups pre-and post treatment.The clinical efficacy was evaluated.ResuIts Compared with control group, the serum level of GPX3 in experimental group increased significantly (P<0.05);WISP2 level in tumor tissue fluid of experimental group increased significantly (P<0.05);FGFBP1 level in tumor tissue fluid of experimental group decreased significantly ( P<0.05 ) .The total efficiency of experimental group was higher than that of control group ( 64.44%vs.42.22%;χ2 =4.46,P<0.05), and the clinical benefit rate of experimental group was significantly higher than that of control group(93.33%vs.75.56%;χ2 =5.41,P<0.05).ConcIusion The irinotecan hydrochloride injection could increased levels of serum GPX3 and WISP2 in tumor tissue fluid, reduce FGFBP1 level in tumor tissue fluid, which has good clinical curative effect.

ObjectiveTo practice second-level prevention of breast cancer, conduct serial experiments on blocking precancerous change of breast cancer thus reduce its incidence rate. MethodsAfter the segment resection of primary lesions the breast precancerous lesions with ductal hyporplasia (DH) atypical ductal hyperplasia (ADH) and ductal intraepithelial neoplasia (DCIS), lobular intraepithelial neoplasia (LCIS) ,detected hormone receptors ER, PR and c-erbB-2, P53 were detected. With individualized comprehensive treatment, the positive patients with ER and PR was treated with tamoxifen; the postmenopausal patients took anastrozole to reduce the levels of estrogen; the positive patients with c-erbB-2 were treated with chemotherapy and the combined treatment; the patients with preoperative diagnosis of malignant cells were taken with the ipsilateral axillary lymph node dissection; all patients were observed and followed up.ResultsThere were 126 cases of the breast precancerous lesions from 1992 to 2008, including 75 cases of ADH with the positive rates of ER and PR 86.6％, c-erbB-2 1.33％, P53 0; 51 cases of DCIS and LCIS with the positive rates of ER and PR 84.6％, c-erbB-2 4％ ,P53 4％ ; Axillary lymph node reactive hyperplasia were 0/9 - 0/18. ConclusionsBreast precancerous lesions of ADH, DCIS, LCIS are local symptoms of the systemic disease, the segment resection of primary lesions and comprehensive treatment ( endocrine, chemotherapy, radiotherapy) based on immunohistochemical expression are effective through which the incidence rate of breast cancer could be largely controlled or suppressed.

OBJECTIVETo observe the effects of Sanhuangyinchi decoction (SHYCD) pretreatment on acute hepatic failure (AHF) induced by D-galactosamine and lipopolysaccharide (LPS) in rats and explore the possible mechanisms involving antioxidant stress and cell apoptosis-related protein expression.

METHODSForty-eight SD rats were randomized equally into control group, AHF model group, high-, medium- and low-dose SHYCD groups, and Bicyclol group. Five days after administration of the corresponding drugs, the rats were challenged with peritoneal D-galactosamine (700 mg/kg) plus LPS (10 ug/kg) injections to induce AHF acute hepatic failure except for those in the control group. At 48 h after the injections, blood samples were collected from the rats to detect the levels of ALT, AST, TBIL, PT, INR and FIB, and pathological changes and superoxide dismutase (SOD) and malondialdehyde (MDA) contents in the liver were examined; immunohistochemistry and western blotting were used to detect caspase-3 protein expression in the liver.

RESULTSThe levels of ALT, AST, TBIL, TP and INR in the 3 SHYCD groups and Bicyclol group significantly decreased (P<0.05) while FIB significantly increased in comparison with those in the model group. SHYCD obviously ameliorated the pathological changes, enhanced SOD activity (P<0.05), and decreased MDA levels (P<0.05) and caspase-3 expression (P<0.05) in the liver tissue. SHYCD at the medium dose produced similar effects to Bicyclol (P>0.05) and showed better effects at the high dose than Bicyclol (P<0.05).

CONCLUSIONSHYCD pretreatment can dose-dependently ameliorate AHF in rats possibly by suppressing antioxidant stress and caspase-3 expression to decrease hepatic cell apoptosis.

Animals ; Caspase 3 ; metabolism ; Drugs, Chinese Herbal ; therapeutic use ; Liver Failure, Acute ; drug therapy ; metabolism ; prevention & control ; Male ; Malondialdehyde ; metabolism ; Oxidative Stress ; Phytotherapy ; Rats ; Rats, Sprague-Dawley ; Superoxide Dismutase ; metabolism

OBJECTIVETo evaluate the clinical features and prognosis of gastric cancer patients with pathological complete response (pCR) after neoadjuvant chemotherapy (NAC).

METHODSClinical data of 159 gastric cancer patients who received NAC followed by surgical resection between January 2012 and December 2014 at the Affiliated Tumor Hospital of Zhengzhou University were collected and clinical features of those with pCR were analyzed retrospectively. Kaplan-Meier method was used to estimate 3-year overall survival (OS) rate and recurrence-free survival (RFS) rate. Recurrence factors were analyzed by univariate and multivariate analysis with Cox proportional hazard model.

RESULTSA total of 21 patients(13.2%) achieved pCR, including 13 male and 8 female cases, with the median age at diagnosis of 56 (40 to 70) years. Eleven cases were differentiated tumor and 10 were undifferentiated. Six cases were in clinical baseline stage II(, and 15 were in III(. Five cases received the mFOLFOX6 (oxaliplatin + leucovorin +5-FU), 6 received the SOX (oxaliplatin +S-1), 4 received the XELOX (oxaliplatin + capecitabine), 2 received the EOX (epirubicin + oxaliplatin +capecitabine) and 4 received the DOX (docetaxel + oxaliplatin +capecitabine) chemotherapy regimens. Two cases achieved CR, 18 achieved PR, and 1 was SD after NAC. The median (range) course of preoperative and postoperative chemotherapy were 4(2 to 5) and 2(0 to 5) . All the patients underwent R0 resection plus D2 lymphadenectomy, and 4 cases were performed with proximal gastrectomy, 3 cases were performed with distal gastrectomy, 13 cases were performed with total gastrectomy, and one case was performed with total gastrectomy plus pancreatic splenectomy. Pneumonia, abdominal bleeding and infection, anastomotic leakage, and gastroplegia occurred respectively in one case, who all were cured by conservative treatment. The median follow-up of the survivors was 39.3 (range 22.7 to 56.9) months. Three cases died of recurrence: 1 case in the liver, 1 in the lung, and 1 in the brain. Two cases developed recurrence and survived: 1 in the liver and 1 in celiac lymph nodes. The overall survival and 3-year recurrence-free survival rates were 90.2%(95%CI: 100 to 77.3) and 90.5%(95%CI: 100 to 78.0). Fourteen cases did not complete scheduled chemotherapy course, and the overall 3-year survival rate was 85.1%. Older age(>50 years old)(P=0.028, RR=0.063, 95%CI: 0.005 to 0.743) and no postoperative complication (P=0.023, RR=0.065, 95%CI: 0.006 to 0.689) were identified as independent prognostic factors with Cox multivariate analysis.

CONCLUSIONPatients diagnosed as gastric cancer with pCR after NAC have good prognosis, but the pCR ratio is low, and those with younger age and more postoperative complications may have higher risk for recurrence and metastasis.

Objective To evaluate the clinical outcome of anterolateral lumbar interbody fusion (ALLIF) for the treat-ment of degenerative lumbar spondylolisthesis(DLS). Methods All of 53 patients with degenerative spondylolisthesis were en-rolled in this study during January 2014 to January 2016. All patients underwent stand-alone ALLIF with self-locked cage, includ-ing 15 males and 38 females with an average of 57.4±11.2 years old. The surgical level included L3,4(4 cases), L4,5(33 cases) and L5S1(16 cases). The operative time, bleed loss and complications were recorded. Clinical outcome was measured by visual analogue scale (VAS), Oswestry disability index (ODI) and the health questionnaire (SF-36). Radiological measures were slippage, disc height, lumbar lordosis, sagittal diameter and area of dural canal, foraminal height and area, and fusion rate. All the data were sta-tistically analyzed. Results All patients were followed up for at least 24 months. The mean operation time was 64.2 ± 12.5 min-utes, and the mean bleed loss was 72.8 ± 14.3 ml. No serious complications such as vascular or nerve injury occurred during peri operation. VAS for low back pain,VAS for leg pain and ODI were significantly decreased from 6.8 ± 1.5,5.6 ± 2.4 and 58.5％± 18.6％preoperatively to 1.6±1.2, 1.2±1.1 and 18.5％±8.8％at 24 months postoperatively.The SF-36 scores were improved signif-icantly from 56.7 ± 12.8 preoperatively to 79.4 ± 14.3 at 24 months postoperatively. Slippage of patients was reduced significantly from 22.5％± 8.3％preoperatively to 5.7％± 2.3％. Disc height and lumbar lordosis were significantly increased from 6.2 ± 1.6 mm and 46.4°±9.2° preoperatively to 10.5±1.4 mm and 53.2°±11.2° at 24 months postoperatively. Sagittal diameter and cross-section-al area of thecal sac were significantly increased from 11.7±2.2 mm and 78.4±28.6 mm2 preoperatively to 13.8±1.6 mm and 112.5± 23.9 mm2 at 6 months postoperatively. Intervertebral foramina height and area were significantly increased from 15.8 ± 4.3 mm and 136.5±25.6 mm2 preoperatively to 19.2±2.5 mm and 157.6±23.1 mm2 at 6 months postoperatively. At 24 months follow-up, the fusion rate was 100％and the subsidence rate was 10.5％. Conclusion Stand-alone ALLIF could achieve satisfactory clinical re-sults and reduction for DLS. Disc height and lumbar lordosis were restored. Efficient decompression was obtained with significant-ly increased sagittal diameter and cross-sectional area of thecal sac and intervertebral foramina height and area. Stand-alone AL-LIF provides a new surgical strategy for the treatment of DLS.