Objective To discuss causes and prevention of complications and recurrence following sphincter preserving procedure(SPP) for rectal cancer.Methods A retrospective study on clinical and follow-up data of 375 cases of rectal cancer treated by SPP from January 2000 to January 2006 was carried out.Factors relating complications and recurrence after the operation were analyzed with the Logistic regression.Results A follow-up was conducted for 1～60 months(mean,37 months).The 5-year survival rate was 75.77%,and 79 cases of those followed died.Postoperative complications included anastomotic leakage in 14 cases(3.73%),anastomotic stenosis in 37 cases(9.87%),and anastomotic bleeding in 13 cases(3.47%).Anastomotic tumor recurrence was seen in 25 cases.Logistic regression analysis showed that the distance between the tumor and the dentate line was the most important factor for postoperative complications(P=0.017),and the distance and patient's age were the most important factors for recurrence(P=0.040,P=0.041). Conclusions The distance of tumor and patient's age are the most important factors for complications and recurrence following sphincter preserving procedure for rectal cancer.Strict selection of patients for surgery,normative procedure performance,and proper peri-operative management are essential for the prevention of complications and recurrence.

Objective: To explore the protective roll of ifbroblast growth factor 21 (FGF21) in endoplasmic reticulum stress (ERS) induced rat's H9c2 cardiomyocyte apoptosis with its mechanism. Methods: pcDNA4 was used as gene vector, pcDNA4-FGF21 plasmid was constructed and transfected into rat's H9c2 myocardiocytes for 48 h. ERS model was established by 10 μM tunicamycin (TM) induction for 24 h. The experiment was conducted in 4 groups:①Control group,②TM group, the cells were treated by TM,③pcDNA4-FGF21+TM group,④pcDNA4+TM group. The expressions of FGF21, protein kinase R-like ER kinase (PERK) and c-Jun N-terminal kinases (JNK) mediated apoptosis pathway related protein were measured by Western blot analysis; cell survival rate was examined by CCK-8 method and apoptosis rate was detected by TUNEL technique. Results: pcDNA4-FGF21 vector was successfully constructed and overexpressed in H9c2 myocardiocytes. Compared with Control group, TM group and pcDNA4+TM group had up-regulated endogenous FGF21 expression, increased PERK and JNK mediated apoptosis pathway related protein expression; reduced cell survival rate and elevated apoptosis rate. Compared with TM group and pcDNA4+TM group, pcDNA4-FGF21+TM group had down-regulated PERK and JNK mediated apoptosis pathway related protein expression; increased cell survival rate and decreased apoptosis rate. Conclusion: FGF21 overexpression can reduce ERS induced apoptosis rat's H9c2 myocardiocytes which might be partly related for inhibiting PERK and JNK mediated signal transduction of apoptosis pathway.

As a useful supplement for TNM staging system of non-small cell lung cancer (NSCLC),circulating tumor cell (CTC) can better reflect the comprehensive condition of the patient.CTC plays an important potential role in monitoring curative effect of lung cancer,and has the effect of real-time detection.With the development of the CTC detection method and the improvement of sensitivity and specificity,clinical studies about CTC will provide more help for prognosis evaluation.

Objective To compare two methods 3D flash and diffusion-weighted images(DWI)in reconstructing the brain surface anatomy,and to evaluate their displaying ability,advantages,limitations and clinical application.Methods Thrity normal cases were prospectively examined with 3 D flash sequence and echo-planar DWI.Three-dimensional images were acquired with volume-rendering on workstation.Brain surface structures were evaluated and scored by a group of doctors.Results Main structures of brain surface were clearly displayed on three-dimensional images based on 3D flash sequence.Average scores were all above 2.50.For images based on DWI,precentral gyrus,postcentral gyrus,superior parietal lobule, superior frontal gyrus,precentral sulcus,central sulcus,postcentral sulcus,intraparietal sulcus and superior frontal sulcus were best shown with average scores between 2.60-2.75,However,supramarginal gyrus, angular gyurs,middle frontal gyrus,inferior frontal gyrus,superior temporal gyrus,lateral sulcus,inferior frontal sulcus could not be well shown,with average scores between 1.67-2.48.Middle temporal gyrus, inferior temporal gyrus,superior temporal sulcus and inferior temporal sulcus can only get scores from 0.88 to 1.27.Scores of images based on 3D flash were much higher than that based on DWI with distinct differentiations,P values were all below 0.01.Conclusion Three-dimensional images based on 3D flash can really display brain surface structures.It is very useful for anatomic researches.Three-dimensional reconstruction of brain surface based on DWI is a worthy technique to display brain surface anatomy, especially for frontal and parietal structures.

Objective To optimize the processing technology for Radix Puerariae simmered with wheat bran.Methods Orthogonal experiment L9(34) was chosen to optimize the technology. The external properties of Radix Puerariae simmered by wheat bran, the content of puerarin and the antidiarrheal effect on mice with diarrhea caused by folium sennae were used as indexes. Comprehensive weighted score was employed to optimize simmering Radix Puerariae with wheat bran technology.Results Processing time was the main affecting factor, while processing temperature had no significant effect. The optimum processing parameters were 100 g Radix Puerariae simmered with 30 g wheat bran at 160℃ for 2 minutes.Conclusion The optimum processing technology was simple and convenient, and with good reproducibility and operability. It is also helpful for the quality control of Radix Puerariae simmered with wheat bran.

A comparative study on the glycolic acid oxidase (GO) of the domestic Spirulina(Arthrospira) platensis (S_(1)) from alkaline lake in Erdos Plateau and the imported S. (A.) platensis (S_(2)) and S. (A.) maxima (S_(3)) as well is made with colorimetric method. The results show that activity of GO (25℃, pH 8.0) of S_(1), S_(2 )and S_(3) is 70.9 U/gFW, 59.6 U/gFW and 80.9 U/gFW respectively; the GO's optimum temperature of S_(1)、S_(2) and S_(3 )is 30℃; the GO's optimum pH value of S_(1 )is 8.6,while that of S_(2 ) 8.2 and that of S_(3) 8.4; the GO of S_(1 )is stable from 0℃ to 35℃ and from pH 7.6 to pH 10.0, while that of S_(2) from 0℃ to 30℃ and from pH 8.0 to pH 9.0 and that of S_(3) from 0℃ to 35℃ and from pH 8.0 to pH 8.6. Adaptive range of S_(1) GO for temperature and pH is wider, and activity at low and high temperature and under strong acidand alkali conditions is higher than that of the imported species.

Aim To investigate the effects of harpagide on cerebral ischemia and the mitochondria mediated Caspase dependent apoptotic signaling pathway in mice.Methods The MCAO was employed to establish MCAO model.When the models were established, the mice were given harpagide (4, 8, 12 mg·kg-1) and edaravone (3.2 mg·kg-1) [0.1 ml·(10 g)-1] by tail vein injection after MCAO immediately.And the model and control mice were given equivalent normal saline by the same way.After MCAO for 6 h, the behavior, volume of cerebral ischemia and pathological changes in the brain were observed.Westernblot was employed to determine the contents of Cyt C in mitochondrion and pro-caspase-3 in endochylema.Results Compared with the model group, harpagide (4, 8, 12 mg·kg-1) could significantly decrease the increased nerve functional score, brain index, brain water content and volume of cerebral ischemia induced by cerebral ischemia.Harpagide (4, 8, 12 mg·kg-1) could reduce the contents of Cyt C in mitochondrion and pro-caspase-3 in endochylema.Conclusion Harpagide may have protective effect on the cerebral ischemia injury in mice, which might be related to the inhibition of the cerebral mitochondria mediated Caspase dependent apoptotic signaling pathway.

The thrombin is a neurotoxic agent,which plays an important role in the course of brain edema and brain injury following intracerebral hemorrhage.This article reviews the neurotoxicity mechanisms of thrombin in intracerebral hemorrhage.

Objective To analyze the relationship between the genetic polymorphisms of uridinediphosphate glucuronosyltransferase 1A9 (UGT1A9) and mycophenolic acid (MPA)pharmacokinetics in Chinese kidney recipients.Methods Gene mutations (C-440T/T-331C,C-2152T,T-275A,T98C) were detected in 196 recipients by PCR-LDR.On the 28th day after transplantation,the plasma samples which were obtained at the time points of predose,0.5 h and 2 h after administration were measured by an immunoassay method (Emit Mycophenolic Acid Assay,Dade Behring).MPA-AUC0-12 was calculated based on these three data.Correlation between single nucleotide polymorphisms (SNPs) and MPA pharmacokinetics was analyzed.Results C-2152T,T-275A and T98C genotypes of UGT1A9 were not found in 196 recipients.The frequency of C-440T/T-331C gene mutation was 14.29% (28/196).The mean value of MPA-AUC0-12 was 40.6±11.8 wild genotype,respectively (P＞0.05).Conclusion C-2152T,T-275A and T98C genotypes of UGT1A9 are scarce in Chinese kidney recipients.In this study,there is no distinct relationship between -440/-331 SNPs and MPA pharmacokinetics in Chinese allograft recipients.

Objective To explore the clinical characteristics and prevention management of death events caused by infections in end-stage renal disease (ESRD)patients undergoing hemodialysis. Methods Clinical data of ESRD patients undergoing hemodialysis in Nephrology Department of Zhongshan Hospital from 1998 to 2008 were retrospectively studied.Death causes,primary diseases,complications,infections,and survival time were analyzed. Results A total of 252 patients died including 162 males(64.29%)and 90 females(35.71%).Average death age was (63.48±14.77)years.In death events,emergency dialysis accounted for 59.52%,and primary glomerular disease was the major primary diseases(27.23%),then diabetic nephropathy(16.90%)and hypertensive nephrosclerosis (14.55%).34.8%death was caused by infections or promoted by infections,secondly by cerebrovascular events(23.6%).The elderly accounted for the majority of infection-associated deaths.48.15%and 38.71%patients with deaths caused or promoted by infections respectively had shorter dialysis duration(<3 months),whose percentage was much higher than those with non-infection-associated deaths (30.34%).Primary infection was still pulmonary infection(77.59%),then blood infection(10.34%)and catheter-associated infection(5.17%).58.62%infection-associated deaths had positive microbiologic test results,and gram negative bacillus accounted for 38.24%.50% of patients with positive test was complicated with fungal infection. Conclusions Infection is a main cause and a critical promotion to death in ESRD hemodialysis patients,besides it is the main cause of death in the elderly (>75 years)and hemodialysis duration within 3 months,which may result in shorter survival.Pulmonary infection and gram negative bacillus combined with fungal infection should be considered in the treatment.Prophylaxis of nosocomial infection and pulmonary infection in hemodialysis patients should be more emphasized.