Irritable bowel syndrome( IBS)is a common functional gastrointestinal disease,relevant investigations on pathogenesis of IBS mainly focus on genetic susceptibility, social psychological stress, visceral hypersensitivity, dysregulation of brain-gut axis,dysbiosis of intestinal flora,and dysimmunity of intestinal mucosa. This article reviewed the correlation between dysbiosis of intestinal microbiota and dysregulation of brain-gut axis in IBS.

Objective To explore the effect of tonifying kidney with traditional Chinese medicine together with estradiol valerate and clomiphene citrate on serum leptin levels in patients with polycystic ovarian syndrome. Method Two hundred and eight patients with PCOS were randomly divided into observation group (n=104) and control group (n=104). Patients in control group and observation group took estradiol valerate and clomiphene citrate, while patients in observation group took Shiying Minlin soup for three months. Crinosity, body temperature, acne&Skin diseases, and menoxenia were recorded; Leptin (LP) and five hormone including follicle stimulating hormone (FSH),luteinizing hormone (LH), prolactin (PRL), estradiol (E 2) and testosterone (T) are determined using euzymelinked immunosorbent assay. Results Crinosity, body temperature, acne&Skin diseases, and menoxenia were improved;the level of FSH, LH, PRL, E 2, T in both observation and control group decreased and the content in observation group are high than that in control group, while LH,T and E 2 are lower. Conclusion Treatment with tonifying kidney with traditional Chinese medicine on polycystic ovarian syndrome can decrease the level of FSH, LH, PRL, E 2, T and LP. Compared with western medicine, tonifying kidney with traditional Chinese medicine showed advantage in the terms of treatment on polycystic ovarian syndrome.

Functional gastrointestinal disease is a group of clinical syndrome of non-organic disease. Its various clinical symptoms have a certain specificity and overlap phenomenon, and the mechanism is not clear. TCM believes thatphychological factorsare an important cause. Emotion failurecan effect spleen and stomach functionthrough liver and heart directly or indirectly.At present, the phychological factors and the relationship between functional gastrointestinal disease are getting attentiongradually. It is recognized that the mechanism of phychological factorsmay be related to brain axis dysfunction, mast cell activation, intestinal flora and so on. This article expounded the above-mentioned mechanism and reviewed the detailed TCM intervention measures to functional gastrointestinal disease in recent years.

Objective To investigate the value of LigaSure vessel sealing system for surgery in gastroenteric cancer. Methods From January to September 2009,44 cases of gastroenteric cancer were operated by using LigaSure vessel sealing system,including 13 cases of gastric cancer, 14 cases of colon cancer, 17 cases of rectum cancer. Laparoscopy was employed in 10 cases. Results All the cases were performed successfully. The operation time was 130-250 min, the blood loss was 50-250 ml, and the number of lymph nodes resected was 4-20. None of the cases had serious complications. Conclusion As an optimal hemostatic tool, LigaSure vessel sealing system is safe and feasible for gastroenteric cancer.

BACKGROUND:Peridental membrane distraction osteogenesis exerts the functions at peridental membrane and leads to tooth movement. Alveolar bone distraction osteogenesis produces tooth movement through the displacement of the whole bone plate.
OBJECTIVE:To establish three-dimensional finite element model of upper and lower jaw of healthy adults under three different conditions, and to compare the stress distribution and distal movement of the models using three-dimensional finite element analysis method.
METHODS:Model 1:three-dimensional finite element model of the canine under normal conditions using a
variety of software;Model 2:three-dimensional finite element model of the canine after distracting osteggenesis of the periodontal ligament;Model 3, three-dimensional finite element model of the canine after reducing resistance and distracting osteggenesis of the alveolar bone. The force loadings were stimulated among these models.
RESULTS AND CONCLUSION:The biggest displacements on those three models occurred in canine crown on 1/3, and the displacement quantity on canine was model 2>model 3>model 1. The biggest equivalent stress concentrated in distal alveolar crest, and the equivalent stress was model 2

Advanced gastric cancer is usually dealt with D2 radical dissection. There are different opinions as to whether it is necessary to perform D3 radical lymphadenectomy.Some scholars thought that properly enlarged radical dissection can improve long-term outcomes for the treatment of advanced gastric cancer.In recent years,laparoscopic D1 and D2 radical dissection of gastric cancer could be carried out in many hospitals.However,the technique and related skills for performing D3 radical lymphadeneetomy through laparoscope remains to be explored.Based on our previous experiences,D3 radical lymphadeneetomy using artery suspension method and medial-to-lateral approach for advanced gastric cancer is proved to be safe and feasihle.

ObjectiveTo evaluate the feasibility, safety and the long-termoutcomes of laparoscopy-assisted distal gastrectomy (LADG) for advanced gastric cancer (AGC).MethodsWe retrospectively analyzed the clinical and follow-up data of 346 cases after LADG from January 2004 to June 2009, compared with 313 cases after conventional open distal gastrectomy (ODG) for advanced gastric cancer at the same period at our hospital. The surgical safety, postoperative complications, survival rate, and the recurrence and metastasis of cancer were compared.ResultsThere was no significant difference at the average time of LADG and ODG procedures (211 ± 56) min vs.(204 ±41 ) min, but blood loss during operation and length of incision in LADG group were significantly less than in the ODG group. The proximal and distal length were, respectively, (6. 3 ± 2. 0) cm and (5. 7 ± 1.7 ) cm in LADG group and (6. 3 ±2. 1 ) cm and (5.6 ± 1.6) cm in ODG group, the difference was not significant. The number of lymph node dissections was also similar: (33 ± 13) in LADG group and (33 ± 16) in ODG group. The incidence of postoperative complications in LADG group was significantly lower than that in ODG group ( 6. 7％ vs.13. 1％, P ＜ 0. 05). During the follow-up period of 6-72 months (average 37 months), the 1-, 3-and 5-year survival rates were, respectively, 87. 2％, 57. 2％ and 50. 3％ in LADG group and 87. 1％, 54. 1％and 49. 2％ in ODG group, the difference was not significant. The differences in recurrence and metastasis between the two groups were not statistically significant.ConclsionLaparoscopy-assisted gastrectomy for advanced gastric cancer is not significantly different with open surgery in postoperative survival rate or recurrence. It is less traumatic and of fewer complications.

The operation path, lymph node dissection and reconstruction of the alimentary tract are the three most technical difficulties of laparoscopy-assisted gastrectomy. The essential difference between laparoscopy-assisted gastrectomy and open gastrectomy is the operation path. Based on our clinical experience, we investigated reasonable paths for laparoscopyassisted gastrectomy. Patients were placed in a supine position with their legs apart, and the operator stood on the left side of the patient. Five trocars were placed in the abdominal wall in a curved line. The operation was carried out in the order of greater gastric curvature, the lower region of the pylorus and antrum,the upper region of the pancreas, omentum minus, cardia, and arcuate diaphragm. From May 2004 to April 2010, we successfully carried out 761 laparoscopy-assisted gastrectomies with satisfactory outcomes.

OBJECTIVETo determine the incidence, risk factors and clinical outcomes of postoperative delirium in colorectal cancer patients over 60 years.

METHODSConsecutive 382 patients older than 60 years undergoing colorectal cancer surgery at Shenzhen Second People's Hospital from June 2013 to June 2016 were recruited prospectively in this study. These patients were evaluated daily after surgery for 7 days by confusion assessment method. Clinical outcomes were compared between patients with and without postoperative delirium, including postoperative complications, length of hospital stay, and mortality within 30 days. Logistic regression analysis was used to identify independent predictors of postoperative delirium.

RESULTSThere were 230 male and 152 female patients with median age of 67(range 60 to 92) years. Among them, 213 had colon cancer and 169 had rectal cancer. Postoperative delirium developed in 46(12.0%) patients, and most deliriums (78.3%) were diagnosed within 3 days after surgery. Patients with postoperative delirium had more complications [30.4%(14/46) vs. 17.3%(58/336), P=0.032], higher mortality [6.5%(3/46) vs. 1.8%(6/336), P=0.047], and longer postoperative hospital stay (median 14 days vs. 9 days, P=0.008). Univariate analysis revealed that advanced age, male, higher Charlson comorbidity index, higher American Society of Anesthesiologists Classification, lower preoperative blood albumin concentration, history of psychiatric disease, history of cerebrovascular disease, alcohol abuse, emergent operation, and perioperative blood transfusion were significantly related to the development of postoperative delirium. Logistic regression analysis identified that advanced age (OR=1.06, 95%CI: 1.01 to 1.13), history of psychiatric disease (OR=10.89, 95%CI: 2.73 to 41.59) and perioperative blood transfusion (OR=2.37, 95%CI: 1.11 to 7.32) were independent risk factors of postoperative delirium.

CONCLUSIONSPostoperative delirium is relatively common in elderly patients over 60 years undergoing colorectal cancer surgery. The high morbidity of postoperative complication and mortality associated with postoperative delirium warrant implementation of preoperative risk assessment and postoperative screening protocol for postoperative delirium. Comprehensively preventive strategies should be carried out for high-risk patients, e.g. advanced age, history of psychiatric disease, and perioperative blood transfusion.

After reviewing literature, this paper will briefly introduce the research progress on toxicity-reducing and efficacy-enhancing through compatibility of Radix Aconiti Lateralis Praeparata in recent years. It includes five parts:modern basic study of Radix Aconiti Lateralis Praeparata; research on toxicity-reducing and efficacy-enhancing of complete or separate prescription of Sini Tang; research of the herb-pair in compatible prescription; studying the efficacy of herbal prescription of Radix Aconiti Lateralis Praeparata by utilizing complex biological networks; further research of Radix Aconiti Lateralis Praeparata and its prospect.