Objective To analyze the relative risk factors of elderly patients with abdominoperineal resection for rectal carcinoma.Methods The risk factors for hospital death and postoperative complications in 137 elderly patients who had undergone abdominoperineal resection for rectal carcinoma from July 1995 to July 2005 were analyzed retrospectively.Results The risk factors included coexistent diseases,hemoglobin level less than 70 g/L,body mass index(BMI)less than 18.5 kg/m2,intraoperative blood loss more than 1 000 ml,operating time longer than 6 h.The relative risk ratio were 4.76,5.85,6.49,5.47,3.90 respectively for hospital death,and 2.02,2.27,1.83,2.01,1.70 for postoperative complications.Conclusion The risk factors of the elderly patients with abdominoperineal resection for rectal carcinoma should be considered carefully during the perioperative period.

Objective To analysis the clinical characteristics of Tubal pregnancy.Methods 500 cases of tubal pregnancy were collected and clinicopathological changes,histopathologic feature were studied in 500 cases of tubal pregnancy,35 cases of them analyzed by electron microscope.Results Patholocal changes of the Fallopian tubes itself:Chronic nonspecific inflammation and peripheral inflammation of Fallopian tubes and endometriosis and the fatty infiltration of the tubal wall is 60%、2%、1.6%、0.8% and 2%.Conclusions The main pathological changes of fallopian tubes itself is chronic nonspecific inflammation.IUD and tubal sterilization and endometriosis and fatty inflitration of the tubal wall be causative of the tubal pregnancy.

Recombinant plasmids pHY-PA, pBBR-PA were constructed in which genes pdc and adhB were placed under the control of tac promoter, respectively, and had successfully expressed in Escherichia coli. Then these recombinant plasmids were electroporated into Lactobacillus strains for ethanol production. Preliminary ethanol fermentation using these Lactobacillus strains and their recombinants was carried out using 42℃ as fermentation temperature. The results indicated that introducing pdc and adhB, ethanologenic pathway was successfully constructed in L.plantanum CICIM B0080. 0.4% (V/V) ethanol was detected at the end of fermentation with 6.7% glucose, and that is 67-fold as the wild-type B0080. Two-fold of ethanol production was detected in L.amylovorus B0112 (pHY-PA) and L.acidophilus B0068 (pBBR-PA). Introducing both pdc and adhB, and meanwhile knock-outing the lactate dehydrogrnase gene may better convert carbon flux to ethanologenic direction.

Objective To investigate the change of high sensitivity c-reaction protein( hs-CRP)on carotid artery plaque. Methods A total of 5 852 individuals were selected as our subjects who randomly stratified from the health examination survey participants in Tangshan Kailuan Company community during 2006 - 2007. A total of 5 440 people(age above 40 years old,free of stroke,transient ischemic attack(TIA)and myocardial infarction ) were qualified and enrolled in the final analysis. A questionnaire survey,blood biochemical analysis and carotid artery ultrasound examination were finished by trained medical staff. According to the hs-CRP 3 mg measurements at the first and third times health examinations,all subjects were divided into four groups,including continued decreasing group(hs-CRP < 3 mg/ L),decreasing group(hs-CRP decreased from≥3 mg/ L to < 3 mg/ L ),increasing group((hs-CRP increased from < 3 mg/ L to≥3 mg/ L)and continued high group((hs-CRP ≥3 mg/ L). Multiple logistic regression analysis was used to test the impact of change of hs-CRP on carotid artery plaque. Results Incidence of carotid artery plaques in continued decreasing, decreasing,increasing and continued high groups were 33. 6%(1 308 / 3 577),44. 7%(178 / 398),45. 1%(186 / 412)and 54. 9%(151 / 275),respectively. The dependent variable was named based on carotid artery plaque(1 = plaque and 0 = no plaque),and in dependent variable was named based on hs-CRP value change (0 = continued decreasing group;1 = decreasing group;2 = increasing group;3 = continued high group). Multiply factors logistic regression analysis showed that the risk of carotid artery plaques for women increased compared to decreasing group( RR = 1. 17,95% CI:1. 01 - 1. 35,P = 0. 035). After adjusting gender,age,smoking,low density lipoprotein cholesterol,fasting blood-glucose,baseline lg( hs-CRP)and body mass index,the risks of developing carotid artery plague in increasing group and continued high group were increased compared to decreasing group among the women and whole population(for all subject:RR = 1. 33,95% CI:1. 04 - 1. 70,P =0. 023;for women subject:RR = 1. 63,95% CI:1. 08 - 2. 46,P = 0. 021). Conclusion Increasing hs-CRP is a risk factors of incidence of carotid artery plaque possibly.

Objective To assess the efficacy of dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) of the breast in the detection of residual lesions of early stage breast carcinoma after lumpectomy. Methods 53 patients with breast masses confirmed to be malignant tumors by pathology after lumpectomy underwent the dynamic contrast-enhanced breast MR imaging and then further surgical treatment by lumpectomy. The DCE MRI-based diagnoses were compared to the results of pathological analyses after the second lumpectomy. Results 17 (32%) cases were detected with abnormal enhancement. 8 cases presented mass-like enhancements , and 6 of them showed tumorous residuals (P < 0.01). 6 presented focal enhancements, taking up 35% and one of them was confirmed pathologically to have tumorous residuals (P < 0.01). 3 cases presented mass-like enhancement, taking up 18% and 2 of them were confirmed with cancerous residuals . MR dynamic enhancement showed 68% of the them presented no abnormal enhancements in the breast and 33 of themhad no residual cancer , taking up 92%. 3 of them were confirmed with tumorous residuals , taking up 8%. The The positive predictive value and negative predictive value of DCE MR imaging for diagnosing residual malignant lesion were 52% and 92%, respectively . Conclusion The dynamic contrast-enhanced MRI of breast is helpful for evaluating residual malignant lesion after lumpectomy and affects positively subsequent treatment.

Objective:To investigate the effects of various bio-adhesive polymers on bio-adhesive characteristics and release rate of 5-fluorouracil HP-β-CD inclusion complex thermo-sensitive gels. Methods: Bio-adhesive polymer, such as hydroxypropylmethylcellu-lose ( HPMC) , sodium alginate ( SA) , sodium hyaluronat ( HA) ,carbopol and polycarbophil was respectively used to prepare the ther-mo-sensitive gels, and the bio-adhesive force was studied. The phosphate buffer (pH 7. 2) was used and the drug release characteris-tics were studied using dialysis technique. Results: The bio-adhesive force of the gels with 0. 2% polycarbophil was 32. 3 g·ml-1 , and the drug release time was prolonged to 8 h. There was no obvious difference in the dissolution among the gels with the various bio-adhesive polymers. Conclusion:Using 0. 2% polycarbophil as the bio-adhesive polymer, 5-fluorouracil HP-β-CD inclusion complex thermo-sensitive gels show good bio-adhesive force and prolonged drug release characteristics.

Objective To study radiation protection of low dose CT scanning in orbit. Methods 126 cases of orbital disease were scanned by original standard parameter (130 kV,100 mA) and two different low dose parameters (130 kV,50 mA and 30 mA) respectively. All the images were reconstructed by different Kernels. The image quality and difference of the CTDIw (weighted CT dose index) of each group were compared. Results CTDIw was 30% of that of the conventional scanning and least when 130 kV 30 mA,but the difference of the image quality compared with that by conventional scanning was highly statistical significance (P0.05). Conclusion Low dose CT scanning (50mA) in orbit not only can assure the image quality but also can decrease the radiation dose.

Objective To evaluate the methods of postoperative respiratory management and complications prevention of patients with myasthenia gravis who received thymectomy. Methods According to the accumulated scores of myasthenic crisis prediction, the patients with myasthenia gravis who underwent thymectomy in the past 5 years were divided into 2 groups: high risk group(12, n=11). The time of mechanical ventilation, restoration of muscle strength and spontaneously breathing during extubation, results of arterial blood gas analysis, body temperature, chest X-ray examination and sputum culture of each patient were analyzed. Results The time of mechanical ventilation in high risk group (18~30 h, 26 h in average) was longer than that in control group(4~28 h, 14 h in average)(P

Objective To explore the damage effect of sonoporation on the prostate of rabbit,while opening up the blood-prostate barrier by microbubble mediated sonoporation.Methods Fifteen male New Zealand white rabbits were randomly divided into 3 groups:ultrasound (US) group,microbubble (MB) group,ultrasound and microbubble (US+MB) group.Ultrasound was insonated directly on the prostate.Optical microscope,electron microscope and apoptosis index (AI) with TUNEL method were applied to trace the changes of the prostate of rabbit under different conditions.Results There was no significant change in prostatic tissues of group US and MB under the optical microscope.Cytoplasm and nucleoli were stained equally,cells of glandular epithelium were intact and formed orderly.Glandular cavities in these two groups were change very slightly.Glandular epithelium cells of Group US+MB were organized optical under the optical microscope,and there was a mass of eosinophilic liquid in the glandular cavities.Vascular endothelial cell were intact and formed orderly and swollen mitochondria were observed under the electron microscope in MB group and US group.Swollen mitochondria,tight junctions among gland cells were opened,and infiltrated erythrocyte could be found under the eletron microscope in US+MB.AI of group US+MB was markedly higher than that of group US and group MB (P<0.01),and AI of group US was higher than that of group MB (P<0.01).Conclusions Microbubble mediated sonoporation causes damage in the prostate tissue of rabbit,while opening up the blood-prostate barrier with an increased permeability of the prostate.

Objective To explore the clinico-pathological features, immunophenotype, treatment and prognosis of urologic primary primitive neuroectodermal tumor (PNET). Methods The clinical data of 3 patients with urologic PNET were analyzed retrospectively. All patients were male, aged 29, 32 and 75 years respectively. Two of the lesions were located in the kidney, and the third was located in the bladder. The sizes of renal tumors were 7.7 cm×6.2 cm and 12.6 cm×9.4 cm respectively. Imaging examinations revealed a well-defined mass with inhomogeneous echo inside. The size of bladder tumor was 10.0 cm×10.0 cm. CT scan demonstrated irregular thickening of the bladder wall, and the density of the wall was inhomogeneous. In the 2 cases of renal PNET radical surgery was performed, while an emergency palliative surgery to remove a blood clot and biopsy were performed in the bladder PNET case. Results In light microscope, the tumors were characterized by uniform small round or oval cells and nest-like or dense sheet structures surrounded by sparse fibrovascular stroma. Homer-Wright rosettes or pseudorosettes were observed, as well as mitoses. Immunohistochemical study revealed that all cases showed positive staining for CD99, synaptophysin and vimentin. One of the renal tumor cells showed positive for CD56, and the other renal tumor and urocystic tumor cells were focally positive for chromogranin A. Additionally, in 1 of the cases of renal tumor there was a high positive rate of 80% for Ki67 staining while the other case showed less than 5%. All 3 cases were eventually diagnosed as PNET. The first renal tumor case was not treated with radiotherapy and chemotherapy postoperatively, and the patient died of recurrence 14 months after surgery. Both the second renal tumor case and the bladder tumor case underwent chemotherapy postoperatively, and they died 4 and 6 months after surgery respectively. Conclusions The urologic primary PNET is a very rare, highly malignant soft tissue tumor, and the diagnosis must be based on pathologic findings and immunohistochemical phenotypes. The multimodal treatment for urologic primary PNET consists of surgery, chemotherapy and radiotherapy.