Objective To compare the differences between laparoscopic-assisted and open resection of rectal carcinoma in respect of peri-operative levels of C-reactive protein (CRP), rest energy expenditure (REE), and visceral proteins. Methods According to patients' choice of operation, either laparoscopic-assisted (n=20, Laparoscopic Group) or open (n=25, Open Group) resection of rectal carcinoma was performed. The levels of CRP and visceral proteins-including albumin (ALB), prealbumin (PRE), transferrin (TRF), and retinal-binding protein (RbP)-were assayed preoperatively and on the 1st, 2nd, and 3rd day postoperatively. The levels of REE were also measured by indirect calorimetry in the morning. Results Compared with the preoperative period, the CRP levels in both groups were significantly increased on the 1st, 2nd, and 3rd day (P0.05). The levels of PRE in the Laparoscopic Group were significantly higher than those in the Open Group on the 2nd postoperative day (P

Objective To explore the influence of Al2O3 nanoparticle (20nm in average) on RP4-mediated conjugation and its mechanism was explored further. Methods Mating was conducted between E.coli HB101(RP4) and Salmonella aberdeen Kauffmann 50312(strR) in saline at 25 ℃ without stirring for 8 h,the concentrations of Al2O3 nanoparticle were 0.005,0.05,0.5,5,50 mmol/L respectively. The initial concentration of donor and recipient were both about 109 cfu/ml(donor per recipient ratio was 1∶3).Later transmission electron microscope(TEM) and laser scan confocal microscope (LSCM) were exploited to investigate cell morphology and structure. Results 5 mmol/L and 50 mmol/L Al2O3 nanoparticle could increase the conjugal transfer frequency by 150-fold and 40-fold respectively. TEM observation on thin section indicated several bacterial were prone to form conjugational junction together in 5 mmol/L and 50 mmol/L Al2O3 nanoparticle treated group,which was rarely seen in control group. Meanwhile the cell envelope of bacterial was significantly damaged upon the treatment by 50 mmol/L Al2O3,which might be the reason why transfer frequency of 50 mmol/L Al2O3 group was less than 5 mmol/L Al2O3 group. LSCM result indicated that Al2O3 nanoparticle might damage cell envelope and the damage was positively related to the accumulation of Al2O3 in bacterial. Conclusion Al2O3 nanoparticle can stimulate RP4 conjugal transfer. Conjugative gene is highly regulated. Al2O3 nanoparticle might modulate conjugative gene expression directly or influence cell membrane permeability and thus modulate the process of conjugation indirectly .

[Objective]To discuss the common complications and the methods of prevention and treatment in the operation of displaced acetabular fracture.[Method]Sixty-six cases with displaced aceuabular fracture were treated operatively from August 2005 to June 2009.Approach included anterior ilioinguinal approach,posterior Kocher-Langenbeck approach,or combined ilioinguinal and Kocher-Langenbeck approach.The functional results and complications were analyzed.[Result]All cases were followed up for an average of 29 months(12-46 months).According to the Matta evaluation,the anatomical reduction of acetabular fracture were in 34 cases,perfect in 25,and unsatisfactory in 7.According to the modified Merle d' Aubigne and Postel clinical evaluation standard,the clinical outcome was graded as being excellent in 23 cases,good in 29,fair in 8,poor in 6.Sciatic nerve injury after operation were noted in 2 hips,osteoarthritis in 14,heterotopic ossification in 10,and avascular necrosis of femoral head in 2.No infection and death were founded in this group.[Conclusion]The important factors to decrease the operative complications of acetabular fracture include correct fracture classification,suitable operative time,good operative approach,proficient technique of reduction and fixation and reasonable perioperative measures.

Objective To explore the surgical treatments through anterior and posterior approaches for anterior and posterior compression of cervical spinal cord. Methods The clinical data of 25 cases of anterior and posterior compression of cervical spinal cord from June 1999 to November 2003 were summarized retrospectively. There were 18 males and seven females with age range of 28-56 years (average 36.4 years). Of all,18 cases were with tricolumnae fractures of cervical spine caused by traffic injury,five with cervical herniation and two with malignant macrophage tumor in vertebral body and annex and vertebral lamina. Results All 25 cases underwent internal fixation decompression with I-stage combination operation of anterior and posterior approaches. Of 18 cases with tricolumnae fractures,one died and 17 recovered in various degrees. In five cases with cervical herniation,the positive sign disappeared basically. Two cases of malignant giant-cell tumor appeared metastatic carcinoma in the lungs 10 months after operation. Conclusions The I-stage combination operation of anterior and posterior approaches is an ideal way for the patients suffering from anteropsterospinal compression in cervical spinal cord. It can not only decompress completely the cervical spinal cord,stabilize the wounded cervical vertebra,but also facilitate nursing and function training and be beneficial to the recovery of spinal cord function.

Objective To investigate the clinical efficacy of atlantoaxial pedicle screw fixation plus bony fusion in treatment of traumatic upper cervical instability.Methods From October 2009 to August 2013,29 patients with traumatic upper cervical spine instability were treated with posterior atlantoaxial pedicle screws.The patients underwent autografting (n =19) and allografting (n =10) for spinal fusion.Surrcal outcomes were recorded including intraopcrativc blood loss,operation time,with or without nerve,blood vessel and spinal cord injury,wound healing and bone fusion rate.Results All operations were completed smoothly with operation time of 110 minutes (range,85-135 minutes) and blood loss of 150 ml (range,80-500 ml).At the follow-up of 10 months to 5 years (mean 18 months),bony fusion was detected for all the patients.Postoperative radiographs verified all patients were bony fusion with satisfactory cervical spine stability.No complications of reduction loss,fixation failure,and spinal cord or vertebral artery injury were observed except for 1 patient with low viruleut infection and 2 with delayed wound healing.Conclusion Single posterior atlantoaxial pedicle screw fixation provides security and reliable stability in treatment of upper cervical instability,however wound healing problems should be taken seriously.

Nasopharyngeal cancer (NPC) is an Epstein–Barr virus-associated malignant tumor. Radiation alone or concurrent chemo-radiotherapy is the principal treatment method and can generally achieve excellent efficacy for NPC patients. However, the prognosis of locoregionally advanced disease or distant metastasis remains poor. Currently, immunotherapy has become a new treatment of sol-id tumors, and it is mainly activating the antitumor immune system of the body. The review aims to explore the progress of immuno-therapy, including adoptive immunotherapy, tumor vaccines, and immune checkpoint inhibitors in NPC treatment.

Objective To investigate the clinical efficacy and toxicity in the use of simultaneous integrated boost intensity modulated radiation therapy (SIB-IMRT) for inoperable locally advanced nonsmall cell lung cancer (LA-NSCLC).Methods Between February 2012 and July 2015,58 pathologically diagnosed inoperable LA-NSCLC patients treated with SIB-IMRT were analyzed.A radiation dose of 50-64 Gy was administered in 1.8-2.2 Gy/fraction (26-30 fractions) to the planning target volume (PTV).Simultaneously,60-70 Gy was administered in 2.0-2.35 Gy/fraction (26-30 fractions) to the planning gross tumor volume (PGTV).Results The median follow-up time was 28.0 months (ranging from 6.0 to 40.0 months).The median overall survival (OS) and progress-free survival (PFS) were 25.0 (95％ CI:23.8-26.2) and 15.0 (95％ CI:11.3-18.7) months,respectively.The 1-,2-year OS were 91.4％ and 51.7％,respectively.The 1-,2-year PFS were 56.9％ and 22.7％,respectively.None of the patients developed grade 4 or 5 pneumonitis and esophagitis.In addition,in the subgroup analysis,the patients with N3 have a higher incident of ≥ grade 2 esophagitis compared with N0-N2,the incident are 29.2％ and 20.6％,respectively (P ＜ 0.05).Conclusions SIB-IMRT is feasible and well-tolerated for inoperable LA-NSCLC patients.It remains to be further evaluated in a large sample size prospective clinical trial.

Objective To investigate the potential differences in efficacy of anterior and posterior cruciate ligaments(ACL &PCL)reconstruction by using arthroscopy between autologous tendon and tendon allograft.Methods A total of 144 patients with ACL or PCL fracture were assigned into two groups,namely anterior tibial muscle tendons allograft(n =82)and tendons autograft(n =63).The graft was fixed by using the Endobutton and Intrafix systems. The general information,drawer test,Lachman test,IKDC score,Lysholm score and Tegner score were compared between groups before and after surgery.The mean follow -up period was 16 months,ranged from 6 to 24 months. Results Both two groups received significant improvement after surgery and met the requirements of ligament reconstruction.However,those patients received autologous tendon had less complications,better knee stability.There were significant differences in Lachman score,ADT/PDT score,IKDC score[(83.43 ±4.37)points vs.(81.05 ± 4.41)points],Lysholm score [(90.59 ±3.43)points vs.(89.03 ±3.25 )points],and Tegner score [(7.79 ± 0.94)points vs.(7.37 ±0.90)points]between the two groups in 12 -month(χ2 =9.509,9.080,t =3.237,2.770, 2.729,all P <0.05).Conclusion The efficacy of autologous tendon is better than tendon allograft in anterior and posterior cruciate ligaments reconstruction,which should be considered has highest priority in treating patients with anterior or posterior cruciate ligaments fracture.

Objective To investigate the efficacy and mechanism of subcutaneously given recombinant Der p 2 entrapped PLGA nanoparticles(DEPN) on mouse model with allergic airway inflammation.Methods 40 BALB/c mice were randomly divided into 5 groups,group A(normal control) were treated with saline(100 ?l) all the time,groups B,C,D and E were sensitized intraperitoneally with crude dust mite extracts(10 ?g) and then subcutaneously treated respectively with PBS(100 ?l),2 mg empty PLGA(EP),100 ?g rDer p 2,and 2 mg DEPN(loaded with 100 ?g rDer p 2) for 3 times,once per day,followed by intranasal challenge of 50 ?g rDer p 2.One day post challenge,mice were sacrificed and bronchoalveolar lavage fluid(BALF) was collected.Number of the total cells and eosinophils was determined,and airway inflammation and mucus secretion were analyzed by haematoxylin and eosin(H&E) staining and periodic acid-Schiff(PAS) staining.Level of cytokines in the supernatant of splenocyte culture was assayed by ELISA.Level of rDer p 2 specific IgG2a and IgE in the sera was determined by ELISA.Results The lung histology showed development of eosinophil infiltration in the airway of mice in groups B and C.The lung inflammation and mucus secretion in groups D and E were significantly alleviated than that of groups B and C.Number of total cells(63.50?5.12) andeosinophils(15.32?3.04) in BALF decreased in group B.Compared with group B,the number of total cells in groups D(55.3?5.20) ? 104 /ml and E(41.00?4.91) ?104 /ml greatly decreased(P

Objective To assess the value of magnetic resonance imaging for acute pancreatitis.Methods 77 patients of acute pancreatitis were examined with holding breath MRI sequence.Transverse scan:2D Flash T 1WI/T 1W+FS,TSE T 2WI+FS or HASTE+FS,Trufisp.Coronals scan:2D Flash T 1W+FS.MRCP was used in 34 patients.2D Flash dynamic contrast enhanced were used in 77 patients.Results 59 cases of acute edematous pancreatitis showed swelling and low signal intensity on T 1WI and higher signal intensity on T 2WI.Excepted the above findings,18 cases of hemorrhagic necrosis pancreatitis alos showed the higher signal intensity on T 1WI and peripancreatic exudative hydrops.Conclusion MRI is a reliable method for demonstrating acute pancreatitis.