Objective To explore regional anatomical features of fascia and spaces related to complete mesocolic excision (CME)dur-ing laparoscopic right hemicolectomy.Methods Observe and describe the regional anatomical features of related mesenterium,fascia and spaces through autopsy and somatoscopy.Results Superior mesenteric vein is the anatomic landmark in CME with medial access for laparo-scopic right hemicolectomy.Right mesocolon and ileal mesentery are the main mesenterium,and the fascia contains the prerenal fascia and the pancreatic fascia.The right retrocolic space and the colon transversum space are two important anatomical spaces,and their fusion fascia space served as a natural surgical plane.Conclusion There is a natural surgical plane which made of mesenterium,fascia and spaces be-tween mesocolon and prerenal fascia in CME during laparoscopic right hemicolectomy,and the surgery is feasible.

BACKGROUND: Studies showed that both anterior cervical disc replacement and anterior cervical decompression and fusion can achieve good clinical result in cervical spondylosis. However, it is not conclusive about which kind of surgical method has an advantage in avoiding the adjacent segment degeneration. OBJECTIVE: To compare the effect on adjacent segment degeneration of single segment cervical disc herniation treated with anterior cervical decompression and fusion and anterior cervical disc replacement. METHODS: We col ected clinical data of 178 patients with cervical disc herniation and receiving anterior cervical disc replacement or anterior cervical decompression and fusion from January 2009 to December 2012. A retrospective analysis was performed. There were 116 cases in the anterior cervical decompression and fusion group and 62 cases in the anterior cervical disc replacement group. RESULTS AND CONCLUSION: (1) Evaluation: visual analogue scale score, Japanese Orthopaedic Association Scores and neck disability index were improved significantly in both groups during final fol ow-up compared with that pre-treatment (P < 0.05). (2) No significant difference in range of motion of operation segment, adjacent upper segment and adjacent lower segment was detected between final fol ow-up and pre-operation in the anterior cervical disc replacement group (P > 0.05). At 3 months after surgery, in the anterior cervical decompression and fusion group, surgical segment was confluent, and range of motion lost. During final fol ow-up, range of motion of adjacent upper segment and adjacent lower segment was significantly increased, and the increased range of motion in the upper segment was bigger than that of the lower segment (P < 0.05). (3) During final fol ow-up, X-ray films and MRI images revealed the number of degenerated adjacent segment was more in the anterior cervical decompression and fusion group than in the anterior cervical disc replacement group (P <0.05). The number of degenerated middle and upper segments was more than that of the lower segment in both groups (P < 0.05). (4) The findings confirmed that anterior cervical disc replacement or anterior cervical decompression and fusion for treating cervical disc herniation could effectively relieve nerve symptoms of patients. However, compared with the anterior cervical disc replacement, adjacent segment degeneration occurs more commonly after anterior cervical decompression and fusion.

Objective To learn the existing state of Keshan disease and its trend in Baoji City,and to provide a scientific basis for control of the disease.Methods Feng,Qianyang,Linyou and Long Counties,the Keshan disease affected areas were selected to carry out the case study,and Keshan cases were searched from all registered cases of myocardial patients of the past three years at county-level medical institutions and hospitals of townships(towns).Thirteen villages affected by Keshan disease in Qianyang,Fengxiang,Feng,Linyou and Long Counties were selected as monitoring points to carry out a intensified monitoring.All subjects were surveyed by comprehensive clinical physical examination and 12-lead ECG tracings,and they were diagnosed according to the Keshan disease diagnostic criteria.Ten households were selected randomly in each monitoring point(village),and self-produced wheat samples and adult subject's occipital hair samples were collected for detecting selenium levels.Results Seven hundred and forty-six cardiac cases which containing 17 cases of chronic Keshan disease were discovered in 32 medical institutions,and there were no acute and subacute type of Keshan disease patients.Five thousand seven hundred and twenty-three subjects were examined in the 13 monitoring sites,and 65 cases of Keshan disease were diagnosed which including 17 cases of slow and 48 cases of potential Keshan disease,and no acute or subacute case was found.The total detection rate was 1.14％,and the detection rate ranged from 0 to 2.86％.Hair selenium mean was 0.420 mg/kg; wheat selenium mean was 0.079 mg/kg.Conclusions The Keshan disease detection rate of Baoji City is at a low level.The selenium level of local residents has reached the level of non-endemic area.Constant detection of patient with Keshan disease means various control measures should be reinforced.The comprehensive monitoring program,such as monitoring people's in vivo and in vitro selenium level and others,should be established as soon as possible.

Objective To investigate the relationship between watching television time and impaired glucose regulation (IGR) , type 2 diabetes mellitus in Chongqing City .Methods Population-based cross-sectional study was conducted to investigated the local permanent staff(lived in Chongqing more than 5 years) who were 40 years old or elder in Chongqing City .Results The overall prevalence rate of IGR and T 2DM was 6 .3% ,5 .6% respectively .The average weekly watching TV time of the samples was (12 .3 ± 10 .1) h .After adjusting for possible confounding factors ,the prevalence rate of IGR and T2DM in patients watching TV time >14 h per week was significantly higher than those watching TV time ≤ 7 h per week(Adjust .OR = 1 .528 ,95% CI = 1 .034 - 2 .121 ;OR = 1 .482 ,95% CI = 1 .133 - 2 .047 ,respectively ) .Conclusion Siting and watching TV time were positively correlated with the risk of IGR ,T2DM .So ,we should actively encourage and promote healthy lifestyles to reduce siting and watching TV time .

OBJECTIVETo observe the correlation between constitution of yin deficiency syndrome (YDS) and polymorphism of HLA-DQA1/treatment response of Peg-lFNalpha therapy in HBeAg positive chronic hepatitis B (CHB) patients, and to explore constitution of Chinese medicine (CM) in response of interferon therapy.

METHODSTotally 120 HBeAg positive CHB patients who were treated with Peg-IFNalpha were enrolled, and assigned to YDS group (59 cases) and non-YDS group (61 cases) according to classification of CM constitutions. All patients were subcutaneously injected with Peg-IFNalpha-2b (1.0 microg/kg body weight) or Peg-IFNalpha-2a (180 microg), once per week. Effective efficacy was primarily judged when complete response (CR) or partial response (PR) was obtained at month 6. Those with CR or PR completed 1 year therapeutic course. HLA-DQA1 gene types were detected by polymerase chain reaction sequence specific primers (PCR-SSP). The distribution difference of CM constitutions in patients with CR or PR and their inter-group HLA-DQA1 allele frequency were compared.

RESULTSDifferent treatment responses of Peg-IFNalpha were observed in CHB patients of two different CM constitutions. The ratio of CR + PR was 61.0% (36/59) in YDS group, obviously lower than that in NYDS group [78.7% (48/61), P < 0. 05]. Patients with CR had a lower allele frequency of HLA-DQA1 * 0501 than those with no-response [14.8% (8/54) vs. 30.6% (22/72)] with statistical difference (P < 0.05). Patients with CR had a higher allele frequency of HLA-DQA1 * 0601 than those with no-response [18.5% (10/54) vs. 5.6% (4/72)] with statistical difference (P < 0.05). The allele frequency of HLA-DQA1 * 0301 was lower in YDS group than in non-YDS group [2. 5% (3/118) vs. 9.8% (12/122)] with statistical difference (P < 0.05). The allele frequency of HLA-DQA1 * 0501 was higher in YDS group than in non-YDS group [33.9% (40/118) vs. 18.9% (23/122)] with statistical difference (P < 0.05). Yet statistical significance was lost after adjustment (Pc > 0.05 for both).

CONCLUSIONSBoth constitutions of CM and HLA-DQA1 gene polymorphism af- fect HBeAg positive CHB patients' response to Peg-INFalpha. Constitutions of YDS and HLA-DQA1 * 0501 was not favorable to response, their association needed to be further studied.

Antiviral Agents ; therapeutic use ; Gene Frequency ; HLA-DQ alpha-Chains ; genetics ; Hepatitis B e Antigens ; blood ; Hepatitis B, Chronic ; drug therapy ; genetics ; Humans ; Interferon-alpha ; therapeutic use ; Medicine, Chinese Traditional ; Polyethylene Glycols ; therapeutic use ; Polymorphism, Genetic ; Recombinant Proteins ; therapeutic use ; Remission Induction ; Yin Deficiency ; genetics

A micropipette aspiration technique was adopted in this study on the viscoelastic properties of phagocytes of atherosclerotic origin. A standard linear solid model (Kelvin model) was employed to fit the experimental data, and the 3 viscoelastic coefficients of the model were used to compare the mechanical properties of the phagocytes in different phases during atherosclerosis development. The experimental results indicated that prior to the formation of atherosclerosis, the deformability of the macrophages matured from monocytes decreased, and their rigidity increased. At the initial stage of atherosclerosis formation, the deformability of the foam-cells decreased further. We believe that the deterioration in the deformability of the cells might reduce their mobility within the arterial wall, thus leading to the genesis of atherosclerosis caused by the stagnation and accumulation of the cells laden with atherogenic lipids within the arterial wall. This finding may have important implication in the researches on arteriosclerosis.
Animals ; Atherosclerosis ; pathology ; Elasticity ; Linear Models ; Male ; Monocytes ; pathology ; Phagocytes ; pathology ; Rabbits ; Random Allocation ; Viscosity

Objective To understand the features of immunoglobulin G4-related diseases and to improve its diagnosis and treatment.Methods The clinical data of 20 cases discharged from our hospital were analyzed retrospectively.Results Twenty cases with IgG4 related diseases were reviewed retrospectively.IgG4-related diseasesis more prevalent in male than in female (14∶6),and the mean age was 58 years.Pancreas and bile ducts were the most commonly affected organs,2 and more than 2 organs were involved in 17 patients.All patients had significantly elevated serum immunoglobulin G4.Histopathological findings included diffuse tissue fibrosis with extensive lymphoplasmacytes infiltration.On immunohistochemical staining,the ratio of IgG4-positive plasma cells to IgG-positive plasma cells was higher than 40％.One patient deceased and one patient was left untreated,other patients responded well to the treatment.Conclusion There is no characteristic clinical symptoms for IgG4-related diseases,and serum immunoglobulin G4 is the essential diagnostic method in suspected cases.IgG4-related diseases can be well controlled with prompt use of glucocorticosteroid.

Objective To investigate the difference of spatial working memory among first-episode patients with deficit and nondeficit schizophrenia. Methods The study recruited 116 first-episode treatment-naive patients with schizo-phrenia, and 60 normal controls. Positive and Negative Syndrome Scale (PANSS) was used to assess symptoms of patients and Schedule for the Deficit Syndrome (SDS) was used to divide schizophrenia patients into deficit group (28 patients) and nondeficit group (88 patients). Spatial Working Memory (SWM) test from the Cambridge Neuropsychological Test Automat-ed Battery (CANTAB) was used to test the spatial working memory function. Results Adjusted for age, gender and years of education, there were significant differences in the performance of between errors of 4 boxes (P=0.03), between errors of 6 boxes (P=0.01), between errors of 8 boxes (P=0.03), total errors (P=0.01) and strategy (P<0.01) between deficit and nondef-icit patients, and both groups were poorer than the control group. The SWM of deficit and nondeficit patients has no corre-lation with the negative symptoms (P>0.05). Conclusion The impairment of SWM was more severe in deficit schizophrenia patients than in nondeficit patients at early stage of the disease, suggesting they are different subtypes of schizophrenia.

Objective To detect biomarker proteins in relation to metastasis by comparing serum protein profiles of primary colorectal cancer patients with or without metastasis. Methods A total of 219 serum samples were analyzed using surface enhanced laser desorption ionization time of flight mass spectrometry(SELDI-TOF-MS).The samples were divided into two groups:the training group consisting of 57 primary colorectal cancer patients、63 metastatic colorectal cancer patients and 42 healthy controls,and the test group consisting of 26 primary colorectal cancer patients and 31 metastatic colorectal cancer patients.Samples in training group were analyzed to identify serum biomarker proteins which could differentiate colorectal cancer patients with or without metastasis.The sensitivity and specificity of biomarker proteins were examined by results from blind test group. Results In the m/z region of 2000～30000,31 proteins had statistically significant difference between primary colorectal cancer patients and healthy controls.The m/z of difierentiated proteins were respectively 3240.7、9289.3、5334.4、4596.1 and 4792.4 according to P value.38 proteins had statistically significant diffefence between metastatic colorectal cancer patients and healthy controls.The m/z of differentiated proteins were respectively 3240.7、9289.3、9184.4、3191.5 and 9340.9 according to P value.Only two protein peaks(9184.4 and 9340.9)were found of statistical difference between primary eolorectal cancer patients and metastatic colorectal cancer patients.The sensitivity and specificity of the combination use of the two biomarkers were respectively 90.3% and 88.5% in the test group. Conclusion SELDI-TOF-MS was helpful to find protein biomarkers with relation to metastasis in colorectal carcinoma patients.

Objective To study the molecular characters of porA and porB genes which encode outer membrane proteins (OMP), and predominated clonal complex of Neisseria meningitidis isolates from Guangdong province. Methods Eighteen Neisseria meningitidis isolates from Guangdong province during year 1967 to 2007 were recovered and reconfirmed by API NH biochemical system, and serogrouped by antiserum. The characters of porA and porB gene were analyzed by DNA sequencing. The allele profiles and the sequence types (ST) were determined by multilocus sequence typing (MLST). Based on their allelic profiles, the evolution relationship was analyzed by PHYLIP software. The predominant clonal complex was determined through comparing with the information of reference strains from the PubMLST database. Results For porA gene, type 20 was more frequently in the variable region (VR) 1 and type 9 in VR2 before year 2004. However, for porB gene, type 4 was more frequently in VR Ⅰ, type7 in VR Ⅳ, type 11 in VR Ⅴ,and type 10 in VR Ⅵ, respectively. The multi-types character was presented in VR Ⅴ and VR Ⅵ after2004. VR Ⅶ and VR Ⅷ can not be found among all the isolates except for one W135 isolate in 2007. Among the seven housekeeping genes, the polymorphism of abcZ was the lowest one with 4 allele numbers, while pgm was the highest one with 13 allele numbers. The predominant clonal complex was ST-5 before 2004. The ST-4821 clone complex appeared in 2004 and caused cases every year since then. More important, highly invasive ST-11 clonal complex firstly appeared in Guangdong in 2007. Conclusion The molecular characteristic of OMP genes presents polymorphism for the Neisseria meningitidis isolates from patients in Guangdong province during 1967 to 2007. ST-5 is the predominant clonal complex before 2004 and the highly invasive clonal complex is circulating in recent 3 years. It suggests that the surveillance based on laboratory should be further enhanced.