New technologies and ideas are constantly emerging recently. With the arrival of the era of minimally invasive surgery, most of the colorectal cancer surgeries can be conducted through minimally invasive techniques. In this study, we discuss the status, characteristics, controversy, and consensus of minimally invasive techniques in colorectal cancer surgery.

Objective To investigate the pathogen and inspection methods of the middle-aged women with constipation and evaluate the accuracy and clinical application of imaging to constipation.Methods First colonic transit test were used to 98 cases of middle-aged women who were diagnosed constipation by doctors,then air-barium double contrast examination were applied.Defecation radiography or simulation rectum defecography were used to those who were diagnosed as outlet obstruction.According to the measure target and diagnostic criteria of professor LU,the results were studied.Results 6 cases were abnormal within 8 cases who were inspected by barium enema.14cases were abnormal within 16 cases who were inspected by defecation radiography.Colonic transit test were used to 74 cases and only 6 cases were normal.16 cases were true slow transmission and 20 cases were false slow transmission.52 cases were outlet obstruction.20 volunteers were inspected by suspension barium sulfate and simulation rectum defecography.Conclusions Air-bariun double contrast examination could discover the organic disease and abnormal of rectum.colonic transit test,defecation radiography and simulation rectum defecography were simply and perfect methods to discover the pathogen of constipation.

BACKGROUND:With elevated medical levels, limb salvage surgery for limb malignant tumor is valuable day by day. At present, the limb salvage surgery has substituted amputation and becomes mainstream and development direction of present surgical treatment of limb tumors. However, so far, there are no unified surgical indications for proximal femur tumor, which are controversial. OBJECTIVE:To investigate the efficacy of artificial total hip arthroplasty combined with extended resection of tumor sections for proximal femoral bone tumors. METHODS:Patients with proximal femoral bone tumors in the Second Xiangya Hospital of Central South University were selected and divided into control group and observation group, with 30 patients in each group. According to the disease, lesion curettage, aneurysm wal inactivation, autologous and (or) al ogeneic bone, mixed bone graft and bone graft fixation were selected to treat the control group. The observation group patients received extended resection of tumor sections and total hip arthroplasty. The operative time, intraoperative blood loss, hospital stay and joint function of two groups were compared. 2 years later, patients were revisited. Metastasis and recurrence rate, death rate and quality of life of two groups were compared. RESULTS AND CONCLUSION:There was no significant difference in intraoperative blood loss and surgery time between the two groups (P>0.05). However, hospital stay of patients in the observation group was shorter than the control group. The excellent and good rate of recovery of joint function (83%) was higher in the observation group than in the control group (53%). The metastasis and recurrence rate within 2 years after surgery (7%) and death rate (3%) were lower in the observation group than in the control group (30%, 23%). Various indicators of quality of life of patients in the observation group were significantly better than the control group (P<0.05). These results confirmed that artificial total hip arthroplasty in the treatment of proximal femur tumors is safe and effective.

ObjectiveThis paper discusses the instructional design of ＂General survey of medical culture＂,to provide the basis for the implementation of the teaching.MethodsThe first round of our teaching situation was concluded,to improve the teaching objectives,content,methods and the content and methods of teaching evaluation.Results The course is a new medical humanities curriculum to improve medical knowledge of the human spirit of nursing students,training the cultural literacy,but the teaching content should be combined with professional features,and teaching evaluation methods should be improved.ConclusionsRigorous designed curriculum,flexible and diverse teaching methods and forms of assessment and suggestions from the students are conducive to the improvement of the course.

Objective To summarize the main nursing point and experience of allogeneic small bowel transplantation.Methods One case underwent allogeneic small bowel transplantation in our hospital on the first of December 2010,the nursing measures were summarized.Results The patient passed the operation well-off,and survived the infection phase and repulsion phase in the transplantation ward.Conclusions Valid preoperative evaluation,taking active measures to prevent intraoperative hypothermia and infection,using self-made vacuum pads to prevent pressure sores during operation,are the guarantees for successful operation.

Myasthenia gravis is autoimmune diseases which mediated with acetylcholine receptor antibody.Based on the studies in rencent years,treatment of MG has made great progress.Thisreview will discuss several aspects,such as immune tolerance induced by dendritic cells,blocking monoclonal antibodies,hematopoietic stem cell transplantion,and provide new ideas and methods for the treatment of myasthenia gravis.

The most common clinical manifestations of Hashimoto’s thyroiditis (HT) are goiter and hypothyroidism. The biochemical thyroid function varies quite widely among patients. Anti-TPO antibodies (TPOAbs) are the most sensitive index to screen HT. The thyroid function deteriorates gradually, and the hypothyroidism is the permanent sequeala of HT. The natural history of HT in children and adolescents is not fully known, and monitoring of thyroid function for all patients should be long-term. Children with hypothyroidism should be treated with levothyroxine replacement therapy.

Objective To investigate incidence and severity of retinopathy of prematurity (ROP)screened by RetcamⅢ and the related factors.Comparative case series were designed.Methods A study was performed among infants who required screening by RetcamⅢ in the second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University,and carried out between May 2012 and April 2013.A total of 1097 infants met the study criteria,and were divided into group Ⅰ (n =333 from outpatient screening) and group Ⅱ (n =764 from inpatient screening).Variables were recorded,including birth weight (BW),gestational age (GA),number of births (NOB,singleton/twins/triplets),gender,neonatal respiratory distress syndrome (NRDS),patent ductus arteriosus (PDA),neonatal asphyxia,neonatal hyperbilirubinemia,intracranial hemorrhage,congenital heart disease,neonatal anemia,neonatal sepsis,necrotizing enterocolitis (NEC),and bronchopulmonary dysplasia (BPD).The results of ophthalmological examinations by RetcamⅢ were also recorded.Spearman correlation analysis was used to identify the variables most significantly associated with ROP.Results There were 98 infants of ROP in group Ⅱ (total 764,12.8％).There was a significant association of ROP with variables (P ＜0.05),including BW,GA,and NOB.There was a significant association of ROP with diseases (P ＜ 0.05),including NRDS,neonatal asphyxia,intracranial hemorrhage,neonatal anemia,neonatal sepsis,NEC,and BPD.However,there was no association of ROP with diseases (P ＞ 0.05),including PDA,neonatal hyperbilirubinemia,and congenital heart disease.Conclusions RetcamⅢ can be used to screen retina of infants.ROP is still the most common eye disease in preterm infants.The incidence of ROP was 12.83％ in Wenzhou.Variables,including BW,GA,NOB,NRDS,neonatal asphyxia,intracranial hemorrhage,neonatal anemia,neonatal sepsis,NEC,and BPD,were the most significant factors associated with ROP.

Objective To study the expressions of matrix metalloproteinase-3 (MMP-3) and osteopontin (OPN) in cervical carcinoma and their relationship with invasion and metastasis. Methods The expression of MMP-3 and OPN were detected in 54 cases of cervical cancer tissues by immunohistochemical SP method. Compared with 15 cases of normal cervical tissues, the relationship was analyzed between both protein expressions and clinical pathology. Results The expression positive rates of MMP-3 and OPN in cervical cancer tissues (70.37 % and 66.7 %, respectively) were significantly higher than those of normal cervical tissues (20 % and 0, respectively), were significantly higher with infiltration depth >1/2 and lymph node metastasis than those with depth≤1/2 and without metastasis , respectively(P <0.05). The expressions of MMP-3 and OPN were related with depth of cervical infiltration and lymph node metastasis of cervical cancer.Expressions between MMP-3 and OPN were significantly positively correlation(r =0.401, P<0.05). Conclusion The expressions of MMP-3 and OPN are correlated with invasion and metastasis of cervical carcinoma.

Objective To investigate the correlation of the the positive rate and necrosis rate of retropharyngeal lymph nodes with the clinical effects of intensity modulated radiotherapy (IMRT) in treatment of nasopharyngeal carcinoma (PNC).Methods Seventy-two patients with PNC,50 males and 22 females,with the median age of 50,underwent IMRT delivered into 33 times.The retropharyngeal lymph nodes involved and positive lymph nodes of neck were delineated on the CT image.The median dose and median fractionated dose for gross tumor volume (GTV) were 70.0 and 2.12 Gy respectively,and the median dose and median fractionated dose for clinical target volume (CTV) were 70.0 and 2.12 Gy respectively.The patients were followed up for 36 (5-54) months.Results The metastasis rate of the neck lymph nodes was 90.3％,the metastasis rates in the regions Ⅰ-Ⅴ were 2.8％,86.0％,51.4％,20.8％,and 37.5％,respectively.The metastasis rate of the retropharyngeal lymph nodes was 79.2％,and specifically the metastasis rates of the left,right,and bilateral retropharyngeal lymph nodes were 51.4％,45.9％,and 18.1％,respectively.The cross metastasis rate was 6.9％.Necrosis of the retropharyngeal lymph nodes was found in 15 cases.The necrosis rates of the left,right,and bilateral retropharyngeal lymph nodes were 21.6％,27.2％,15.4％,respectively.Retropharyngeal lymph nodes metastasis was significantly correlated with N stage and clinical stage(Fuzhou 92:r =-0.383,-0.314,P ＜ 0.05 ; UICC:r =-0.434,-0.306,P ＜ 0.05).Local recurrence was observed in 4 patients,6 patients had distant metastasis,and 7 patients died.The positiveness of retropharyngeal lymph nodes was significantly correlated with the recurrence rate,distant metastasis rate,survival rate,and disease free survival rate (r =0.085,0.138,-0.140,-0.124,P ＜ 0.05),and the necrosis of the retropharyngeal lymph nodes was significantly correlated with the recurrence rate and distant metastasis rate (r =0.256,-0.057,P ＜ 0.05),and not significantly correlated with the survival rate and disease free survival rate.Conclusions Retropharyngeal lymph nodes metastasis in NPC is correlated with the N stage and clinical stage.The positiveness of retropharyngeal lymph nodes is significantly correlated with local recurrence,distant metastasis,and survival.Necrosis of retropharyngeal lymph nodes in NPC is significantly correlated with local recurrence and distant metastasis after IMRT.