Objective To investigate the expression of COX-2 and angiogenesis in colorectal carcinoma tissue.Methods The expressions of COX-2 and MVD of 88 cases of colorectal carcinoma and 20cases of control tissue were examined by immunohistochemical staining. Results Compared with normal control,positive expression rates of COX-2(3/20 vs 64/88),and CD34(7/20 vs 74/88)of colorectal carcinoma tissue increased significantly(P＜0.05).MVD in COX-2 positive expressed tissue(63.24-20.4)was higher than that in COX-2 negative expressed tissue(41.2±29.8)(P＜0.01).Conclusion COX-2 is overexpressed in colorectal carcinoma tissue,which may have a strong relationship with MVD.

The purpose of this study is to investigate the enantioselectivity of norgestrel (NG) transdermal permeation and the potential influence of linalool and lipids on the enantioselectivity. In vitro skin permeation studies of NG across the excised rat skins were performed with Valia-Chien diffusion cells, and the permeation samples were analyzed by enantioselective HPLC. The possible enantioselective permeation of NG across intact rat back skin and lipids extracted rat back skin and the influence of linalool were evaluated. The skin permeation rate of dl-NG was two times higher than that of l-NG when donor solutions (EtOH/H2O 2 : 8, v/v) containing l-NG or dl-NG. It may be mainly attributed to the solubility discrepancy between enantiomer and racemate. The enantioselective permeation of dl-NG across intact rat skin was observed when the donor solutions containing dl-linalool. The permeation flux of l-NG was 22% higher than that of d-NG. But interestingly, the enantioselective permeation of dl-NG disappeared under the same experimental condition except that the lipid extracted rat skin was used. Attenuated total reflection-fourier transform infrared spectroscopy analysis of stratum corneum showed that the wave number for asymmetric CH2 stretching vibrations of lipids treated with dl-linalool was greater than that of the control. The results indicated that the enantioselective permeation of NG may be contributed by the interaction between dl-linalool and lipids. More than half of lipids were composed of ceramides. The stereospecific interaction maybe existed among chiral enhancer (linalool), lipids (ceramides) and/or chiral drugs (NG).

Objective To evaluate the value of ultrasound in the diagnosis of congenital intestinal malrotation and midgut vovulus.Methods The findings of ultrasound of 161 children with clinically suspected intestinal malrotation were analysed retrospectively,and were compared with the results of the operation and/or the upper gastrointestinal contrast study.Results The positive sign of ultrasound for congenital intestinal malrotation was that the superior mesenteric vein(SMV) being located at the left of the superior mesentery artery(SMA),or being directly anterior to the SMA,and the positive sign for midgut vovulus was clockwise whirlpool sign (clockwise rotation of the small bowel,its mesentery and the SMV around the SMA).The sensitivity of ultrasound for congenital intestinal malrotation was 82％,and the specificity was 94％.Those for midgut vovulus were 94％ and 94％ respectively.Conclusions Special sign as the superior mesenteric vein(SMV) being located at the left of the superior mesentery artery(SMA) strongly indicate congenital intestinal malrotatione,and the clockwise whirlpool sign means great possibility of midgut vovulus.

Objective To investigate the virus-carrying rate of non-polio enteroviruses ( NPEV) in patients with acute flaccid paralysis ( AFP) in Yunnan province of China in 2015 and to analyze the genetic characteristics of enterovirus 71 (EV71) strains. Methods A total of 213 cases under 15 years old with AFP were reported by Center for Disease Control and Prevention ( CDC) of Yunnan Province of China. Virus isolation was conducted for all samples and the serotypes of isolated NPEV strains were identified by VP1 se-quencing. The isolation rates of NPEV in the past consecutive 5 years were analyzed by SPSS22. 0 software. Phylogenetic trees of NPEV and EV71 strains were constructed by MEGA6. 06 software based on neighbor-joining algorithm and Kimura 2-parameter substitution model and the reliability of the phylogenetic trees was determined by bootstrap analysis with 100 pseudo replicate datasets. Results Altogether, 23 NPEV strains were isolated from 213 AFP cases. Among the 23 strains, 7 strains belonged to EV-A group (2 serotypes, 6 strains of which were EV71 ) , 14 strains belonged to EV-B group ( 8 serotypes ) and the other 2 strains belonged to EV-C group. No NPEV strains of EV-D group were identified. Statistical analysis showed that no significant differences in the isolation rates were observed in the past 5 years ( P=0. 101 ) . Conclusion The isolation rate of NPEV in patients with AFP in Yunnan province in 2015 was similar to that of the previ-ous years. The EV71 strains of C4 subgenotype were the predominant strains circulating in Yunnan province.

Objective To investigate the value of electronic bronchoscopy in the diagnosis of children respiratory diseases. Methods The electronic bronchoscopy results in 400 children with respiratory disease were retrospectively analyzed. Results In 400 children, there were 246 cases with simple endobronchial inflammation, 67 cases with bronchial malacia, 38 cases with bronchial stenosis, 23 cases with bronchial foreign , 4 cases with tracheal bronchus, 4 cases with epiglottic cyst, 3 cases with bronchiectasis, 3 cases with endobronchial granulation, 3 cases with laryngomalacia, 2 cases with vascular ring compression of the trachea, 2 cases with laryngeal web, 1 case with subglottic cyst, 1 case with subglottic neoplasm, 1 case with tracheoesophageal fistula, 1 case with bronchial atresia (left) and 1 case with trachea cyst. All the children had no serious complications. Conclusions Electronic bronchoscopy can effectively improve the level of diagnosis and treatment of children' s respiratory system disease, and it is worth of clinical promotion.

Odontoma is one of the most common odontogenic tumors in the jaws, and it is widely considered as tooth hamartomas. This article reports a rare compound odontoma with 39 denticles which was checked and diagnosed radically by CBCT, and relevant literatures are reviewed.

Objective:To discuss the ultrasonographic features of ganglioneuroma(GN), ganglioneuroblastoma-intermixed(GNBi), ganglioneuroblastoma-nodular(GNBn), neuroblastoma(NB) in children and to improve the ultrasound diagnostic accuracy of four kinds of neuroblastic tumors.Methods:Two hundred and seventy-nine patients with neuroblastic tumors(23GN, 44GNBi, 86GNBn, 126NB) confirmed by surgery and pathological diagnosis in Children′s Hospital Affiliated to Capital Institute of Pediatrics from June 2014 to February 2019 were retrospectively analysed. The ultrasonographic data were summarized and compared with pathological results.Results:The median age were 6.9 years in GN group, 3.9 years in GNBi group, 3.0 years in GNBn group and 2.0 years in NB group. The median values of serum neuron-specific enolase(NSE) were 6.3 μg/L in GN group, 9.6 μg/L in GNBi group, 22.6 μg/L in GNBn group and 40.7 μg/L in NB group respectively. There was no distant metastasis of GN, while 9% GNBi, 26% GNBn and 36% NB had distant metastasis; GN and GNBi group had no invasion to adjacent tissues and organs, while 9% GNBn and 15% NB lesions had invasion to adjacent tissues and organs; 91% GN, 70% GNBi, 58% GNBn lesions had complete capsule, while 44% NB lesions had incomplete capsule and 28% NB had no capsule; 96%GN, 57%GNBi lesions were round or oval, while 57%GNBn, 60%NB lesions showed irregular shape; 96%GN showed homogeneous hypoechoic, 75% GNBi had "cloudy" inhomogeneous echoe, while hyperechoic nodules were seen in 59% GNBn and 75% NB lesions; 65%GN lesions contained discrete and punctate calcifications, while 27%GNBi, 29%GNBn, 25%NB lesions contained coarse calcifications; 100%GN, 91%GNBi, 91%GNBn lesions had little to moderate blood flow, while 33%NB lesions had abundance blood flow; 4%GN, 41%GNBi, 51%GNBn, 49%NB lesions surrounded blood vessels; 13%GN, 5%GNBi, 6%GNBn, 8%NB lesions had spinal canal invasion; GN had no lymph node metastasis, but 48%GNBi, 59%GNBn, 56%NB lesions had lymph node metastasis.Conclusions:The ultrasonographic characteristics of GN are largely different from GNBi, GNBn and NB; There are some differences in ultrasonographic features of GNBi, GNBn and NB, but some of them are difficult to identify.

Objective To investigate the influence of body configuration on the therapeutic effects of totally laparoscopic and laparoscopy-assisted radical total gastrectomies.Methods The retrospective cohort study was conducted.The clinicopathological data of 677 patients with gastric cancer who underwent laparoscopic radical total gastrectomies in the 11 clinical centers [100 patients in the First Affiliated Hospital of Army Medical University (Third Military Medical University),98 in the First Affiliated Hospital of Nanjing Medical University,94 in the First Affiliated Hospital of Nanchang University,89 in the First Affiliated Hospital of Xiamen University,81 in the Affiliated Hospital of Qinghai University,81 in the First Affiliated Hospital of Xinjiang Medical University,42 in the First Affiliated Hospital of Xi'an Jiaotong University,39 in the Traditional Chinese Medicine Hospital of Guangdong Province,26 in the First People's Hospital of Hangzhou City,17 in the Second Affiliated Hospital of Jilin University and 10 in the Xijing Hospital of Air Force Medical University (Fourth Military Medical University)] from January 2015 to June 2017 were collected.Among 677 patients,305 [89 patients in the First Affiliated Hospital of Army Medical University (Third Military Medical University),28 in the First Affiliated Hospital of Nanjing Medical University,14 in the First Affiliated Hospital of Nanchang University,26 in the First Affiliated Hospital of Xiamen University,75 in the Affiliated Hospital of Qinghai University,14 in the First Affiliated Hospital of Xinjiang Medical University,10 in the First Affiliated Hospital of Xi'an Jiaotong University,10 in the Traditional Chinese Medicine Hospital of Guangdong Province,19 in the First People's Hospital of Hangzhou City,13 in the Second Affiliated Hospital of Jilin University and 7 in the Xijing Hospital of Air Force Medical University (Fourth Military Medical University)] undergoing totally laparoscopic total gastrectomy were allocated into the totally laparoscopic group,and 372 [11 in the First Affiliated Hospital of Army Medical University (Third Military Medical University),70 in the First Affiliated Hospital of Nanjing Medical University,80 in the First Affiliated Hospital of Nanchang University,63 in the First Affiliated Hospital of Xiamen University,6 in the Affiliated Hospital of Qinghai University,67 in the First Affiliated Hospital of Xinjiang Medical University,32 in the First Affiliated Hospital of Xi'an Jiaotong University,29 in the Traditional Chinese Medicine Hospital of Guangdong Province,7 in the First People's Hospital of Hangzhou City,4 in the Second Affiliated Hospital of Jilin University and 3 in the Xijing Hospital of Air Force Medical University (Fourth Military Medical University)] undergoing laparoscopy-assisted total gastrectomy were allocated into the laparoscopy-assisted group.All patients received laparoscopic radical total gastrectomy and D2 lymphadenectomy using routine five-port method.Roux-en-Y anastomosis was applied for digestive tract reconstruction,and digestive tract reconstruction was performed under laparoscopy in the totally laparoscopic group and via upper abdominal median incision in the laparoscopy assisted group.Observation indicators:(1) surgical and postoperative situations;(2) stratified analysis:surgical and postoperative situations of obese patients [body mass index (BMI) ＞ 25.0 kg/m2,the maximum vertical distance between the anterior abdominal skin and the back skin at the level of the xiphoid bone (X-APD) ＞ an average value of 22.7 cm and X-APD/the maximum horizontal distance of a plane at a right angle to X-APD (X-TD) ＞an average value of 0.8] between groups;(3) follow-up and survival situations.Follow-up using outpatient examination and telephone interview was performed to detect the postoperative overall survival and tumor recurrence or metastasis up to July 2017.Measurement data with normal distribution were represented as x±s.Comparison between groups was analyzed by the t test.Measurement data with skewed distribution were described as M(Q),and comparison between groups was analyzed by Mann-Whithey test.Comparisons of count data were analyzed using the chi-square test.Results (1) Surgical and postoperative situations:all the patients in the 2 groups underwent successful operations,without perioperative death.Esophagojejunostomy methods of 305 patients in totally laparoscopic group:conventional circular stapler method were performed in 107 patients,antipuncture circular staplar method in 6 patients,OrVilTM method in 5 patients,functional end-to-end esophagojejunostomy method in 76 patients,peristalsis side-to-side esophagojejunostomy method in 106 patients and π esophagojejunostomy method in 5 patients.Three hundred and seventy-two patients in the totally laparoscopic group received conventional circular stapler method,including 361 with end-to-side esophagojejunostomy method and 11 with half end-to-end esophagojejunostomy method.Total operation time,time of esophagojejunostomy,length of assisted incision and using time of analgesics were respectively (235± 72)minutes,(33 ± 15)minutes,(5.6± 1.4) cm,(2.0 ± 1.2) days in the totally laparoscopic group and (223± 63) minutes,(29 ± 10) minutes,(8.0 ± 2.6) cm,(2.3 ± 1.6) days in the laparoscopy-assisted group,with statistically significant differences between groups (t =2.383,3.289,-15.236,-2.780,P ＜ 0.05).The eases with postoperative overall complications,anastomosis bleeding,anastomosis stricture,anastomosis leakage were respectively 38,6,11,11 in the totally laparoscopic group and 35,7,10,13 in the laparoscopy-assisted group,with no statistically significant difference between groups (x2 =1.621,0.007,0.470,0.006,P＞0.05).All the patients with postoperative complications were cured by symptomatic treatment.(2) Stratified analysis:length of assisted incision,using time of analgesics,time to postoperative anal exsufflation,time for initial fluid diet intake,time for initial semi-fluid diet intake,time of postoperative drainage-tube removal and duration of postoperative hospital stay in obese patients with BMI＞25.0 kg/m2,X-APD＞22.7 cm and X-APD/X-TD＞0.8 were respectively (5.9±1.3)cm,(5.7±1.4)cm,(5.6±1.4)cn,(2.0±1.2) days,(2.2±1.1)days,(2.1±1.1)days,(3.4±0.9) days,(3.3±0.9)days,(3.3±0.8)days,(4.7±1.1)days,(4.1±2.0)days,(4.0±1.6)days,(6.6±1.5)days,(6.4±2.3)days,(6.3±1.9)days,(7.8±2.3)days,(7.8±2.7)days,(7.6±2.9)days,(9±4)days,(10±5)days,(10±5) days in the totally laparoscopic group and (8.7±3.1)cm,(8.9±3.0)cm,(8.8±2.8)cm,(2.4±1.3)days,(2.5±1.5)days,(2.5±1.6)days,(3.7±1.0)days,(3.8±1.1)days,(3.7±1.3)days,(5.3±1.7)days,(4.8±1.7)days,(5.0±1.9)days,(7.4±2.3)days,(7.8±2.0)days,(7.0±2.2)days,(8.7±2.4)days,(8.4±1.9)days,(8.1±1.5)days,(1 1±8)days,(11±5)days,(1 1±5)days in the laparoscopy-assisted group,with statistically significant differences between groups (t =-7.950,-2.246,-2.222,-2.500,-2.771,-2.404,-2.251,P＜0.05).There were statistically significant differences in above indicators of patients with X-APD＞22.7 cm between groups (t =-12.089,-2.064,-3.732,-3.220,-5.297,-2.074,-2.208,P＜0.05),and in above indicators of patients with X-APD/X-TD＞0.8 between groups (t =-13.451,-2.736,-3.354,-4.961,-3.280,-2.137,-2.127,P＜0.05).(3) Follow-up and survival situations:of 677 patients,645 were followed up for 1-31 months,with a median time of 12 months,including 283 in the totally laparoscopic group and 362 in the laparoscopy-assisted group.During the follow-up,cases with overall survival,tumor recurrence and tumor metastasis were respectively 255,18 and 21 in the totally laparoscopic group and 327,25 and 20 in the laparoscopy-assisted group (11 and 10 patients in the totally laparoscopic and laparoscopy-assisted groups with simutaneous tumor recurrence and metastasis),showing no statistically significant difference between groups (x2 =0.009,0.076,0.959,P ＞ 0.05).Conclusions Totally laparoscopic and laparoscopy-assisted radical total gastrectomies are safe and feasible in obese patients,with the equivalent time of esophagojejunostomy.Totally laparoscopic radical total gastrectomy is of benefit to short-term recovery of patients.

With aim to reasonably cope with the elderly patients with hip fracture during epidemic of corona virus disease 2019 (COVID-19), Professor Su Jiacan and Academician Zhang Yingze organized the "expert consensus on elderly patients with hip fractures under epidemic of novel coronavirus pneumonia" that for the first time formulated the management strategies for the elderly patients with hip fracture including selection of surgical methods and protective measures for medical staff from perspective of orthopedic surgeons. The authors interpret the clinical guiding value and key points of diagnosis and treatment of the consensus to help clinicians better understand the consensus and strengthen its practical application.

TSCI have dyskinesia and sensory disturbance that can cause various life-threaten complications. The patients with traumatic spinal cord injury (TSCI), seriously affecting the quality of life of patients. Based on the epidemiology of TSCI and domestic and foreign literatures as well as expert investigations, this expert consensus reviews the definition, injury classification, rehabilitation assessment, rehabilitation strategies and rehabilitation measures of TSCI so as to provide early standardized rehabilitation treatment methods for TSCI.