Objective To compare the safety and effectiveness of two methods of perineal dissection in 60 consecutive patients of rectal carcinoma undergoing combined abdominoperineal resection.Methods In this retrospective study from 2007 to 2009, 30 cases underwent Miles' operation using modified method of perineal dissection( MM group) and 30 cases undergoing Miles' operation using classic method of perineal dissection ( CM group). Operative time, accidental tumor ( or rectal) perforation during the procedure, iatrogenic injury to the urethra ( or vagina) and postoperative perineal complications were compared between the two groups. Results The mean perineal operative time was (45±15) min in MM group and ( 70 ± 20) min in CM group respectively ( t = 5. 48, P ＜ 0. 05 ). There were no significant differences in the rate of tumor ( or rectal) perforation and that of urethral (vaginal) injury. There were significant difference in the rate of postoperative perineal complications (χ2=4.01, P＜0.05).Conclusions Modified method of perineal dissection is effective and safe, and this method offers a new approach for the perineal dissection during Miles' operation.

Objective To study the curative effect and side effect of thalidomide incorporation with NP in treatment of Ⅲ/Ⅳ lung cancer. Methods 36 lung cancer patients were randomly divided into three groups. The patients in experimental group were treated by NP plus thalidomide while without thalidomide in the control group. The difference between the first experimental group and second group is that the above used DDP followed with lobaplatin. The beginning dose of thalidomide was 100 mg/d, increase 50 mg/d every week till 400 mg/d, maintain for at least three months. Results The first experimental group had 4 partial relief cases (34.0 %), 5 improved cases(33 %), total efficacy rate was 34.4 %(4/15), clinical benefice rate 49 %(7/ 15), and the second group was 38 %(4/11), 27 %(3/11), 38 %(4/11), 55 %(6/11). All without significant difference. Conclusion It would be valuable to do clinical research further and widespread popularization study for evaluation of Thalidomide incorporation with NP in treatment of Ⅲ/Ⅳ lung cancer.

Objective:This study aimed to observe the curative effect and adverse reaction of docetaxel combined with intraperitoneal cisplatin chemotherapy and hyperthermia treatment of advanced ovarian cancer. Methods:A total of 83 patients with inoperable and recurrent advanced ovarian cancer were randomly divided into two groups:hyperthermia group and control group. The hyperthermia group consisted of 42 cases of docetaxel chemotherapy immediately treated with intraperitoneal cisplatin chemotherapy combined with abdominal local hyperthermia. The control group included 41 cases of docetaxel chemotherapy and intraperitoneal cisplatin chemotherapy treatment only. Results:The total efficiencies of the hyperthermia treatment group and the control group were 81%and 58.1%, respectively, which showed that the total efficiency significantly improved (P<0.05). The ascite control rates were 78.3%and 66.7%and CA125 decreased by 84.2%and 61.5%for the hyperthermia and control groups, respectively. The main adverse reactions were gastrointestinal reaction and bone marrow suppression. However, differences were not statistically significant. Conclusion:Docetaxel combined with cisplatin intraperitoneal perfusion hyperthermia significantly improved the curative effect on advanced ovarian cancer without increasing toxicity, which indicates that it is a treatment worth popularizing.

AIM:To detect the changes of cardiac functions of septic mice in the early stage of sepsis. METHODS:Health male Kunming mice were used in the study. The techniques of 2D,Mmode and Doppler echocardiography were applied to evaluate the cardiac functions before cecal ligation and puncture(CLP) as baseline and at time points of 12 h,24 h,36 h,48 h and 168 h after CLP. The mice survived for 168 h(7 d) were considered as survivals. RESULTS:Compared to the baseline at the time point of 24 h after CLP,the blood volumes of heart return decreased significantly in the early stage of sepsis induced by CLP. LVEDV reduced by 46%. Notable compensatory responses of the hearts in septic mice were observed,especially the systolic functions,in which LVEF and LVFS increased by 27% and 39% ,respectively. However,the compensatory responses of diastolic function were weaker than the systoles. E/A ratio and EDT decreased by 30% and 25% respectively at the time point of 24 h. CONCLUSION:The strong compensatory cardiac functions are one of the factors for supporting the septic animal to survive. Protection of the cardiac functions especially the diastoles is important in the treatment of septic patients.

The expression of X-linked inhibitor of apoptosis protein (XIAP) gene and its effect on chemotherapeutic sensitivity in bladder carcinoma was explored. By using immunohistochemistry, the expression of XIAP was detected in 47 bladder carcinomas and 5 normal bladder tissues. The XIAP gene was transfected into bladder cancer cell line T24 by liposome and the positive clone was screened by G418. Cellular XIAP mRNA level was detected by RT-PCR. Low-dose mitomycin C was administered to induce the apoptosis of T24 cells. The in vitro growth of bladder carcinoma cells was analyzed by MTT colorimetry, and the apoptosis rate was assayed by TUNEL methods. It was found XIAP was moderately expressed in bladder carcinomas with the the positive rate being 78.73% (37/47), but the positive rate was not correlated with carcinoma stages and grades (P<0.05). XIAP mRNA level in transfected T24 cells was significantly increased by 3.8 times as compared with that in the cells not transfected with XIAP. After treatment with low-dose mitomycin C (0.005 and 0.05 mg/mL), the growth rate in XIAP no-transfected control group was increased by (11.60+/-0.25)% and (16.51+/-0.87)% (P<0.05), and the apoptosis rate was decreased by (10.1+/-0.2)% and (11.9+/-0.2%) (P<0.05) respectively as compared with XIAP transfected group. It was concluded that XIAP was expressed in most of bladder carcinoma samples. Overexpression of XIAP in T24 could significantly reduce the MMC-induced apoptosis of bladder carcinoma, suggesting its effect on the chemotherapeutic sensitivity of T24 cells.

Objective:To study the influence of bone morphogenetic protein-7 ( BMP-7 ) on chondro-cyte secretion and expression of type Ⅱ collagen ( Col-Ⅱ) , aggrecan ( AGG ) and SRY-related high mobility group-box gene 9 ( Sox9 ) mRNA in porous tantalum-chondrocyte composites.Methods: The articular chondrocytes were isolated from 3-week-old New Zealand immature rabbits and identified.The 2nd generation of chondrocytes with 1 ×106/mL inoculate concentration was seeded in porous tantalum and divided into 4 groups, and control group ( tantalum/chondrocyte) , 50μg/L BMP-7 group (50μg/L BMP-7/tantalum/chondrocyte) , 100 μg/L BMP-7 group ( 100 μg/L BMP-7/tantalum/chondrocyte ) , and 200 μg/L BMP-7 group ( 200 μg/L BMP-7/tantalum/chondrocyte ) .The proliferation of chondro-cytes was measured by CCK-8 assay.The chondrocyte growth and morphology were observed by scanning electron microscopy ( SEM) .The synthesis of glycosaminoglycan ( GAG) in chondrocytes was tested by dimethyl methylene blue ( DMMB) colorimetric quantification method.Col-Ⅱ, AGG and Sox9 mRNA in chondrocytes were detected by real-time PCR.Results: The chondrocytes were spindle-shaped in 24 hours of primary cell culture and most cells became polygonal shaped in 4 days.The chondrocytes were affirmed by alcian blue, safranin O and Col-Ⅱimmunocytochemistry staining.The result of CCK-8 assay showed that the level of cell proliferation in 100 μg/L BMP-7 groups were higher than those in the other groups ( P<0 .05 ) .The chondrocytes implanted into porous tantalum scaffolds with BMP-7 had better functions, by which cytoplasmic processes developed and extended to the surface and inner of porous tan-talum by SEM observation.DMMB quantitative determination of GAG showed that GAG amount of chon-drocytes in 100 μg/L BMP-7 groups was significantly higher than those in the other groups ( P<0 .05 ) . The expressions of Col-Ⅱ, AGG and Sox9 mRNA in chondrocytes were up-regulated in the experimental groups, compared with the control group and the best effect appeared when concentration of BMP-7 was 200μg/L.(P<0.05).Conclusion:BMP-7/tantalum/chondrocytes composites enhanced in vitro chon-drocyte proliferation and extracellular matrix greatly, and can promote chondrogenic gene expression.

Calbindin 2 ; metabolism ; Heart Neoplasms ; metabolism ; pathology ; surgery ; Humans ; Male ; Middle Aged ; MyoD Protein ; metabolism ; Myogenin ; metabolism ; Rhabdomyosarcoma, Embryonal ; metabolism ; pathology ; surgery

Objective To compare the short-term results of laparoscopic-assisted with open surgery for primary rectal cancer in elderly patients. Methods The medical records of forty-nine elderly patients (≥70 years) with laparoscopic-assisted resection and fifty-five cases (≥70 years) with open surgery for rectal cancer were retrospectively reviewed. Results There were no thirty-day mortality in both groups. Operative procedure and operating time did not differ significantly in laparoscopic-assisted group (LAG) and open group (OG), and blood loss was significantly greater in OG (P =0.031). The rate of postoperative complications was lower (12.2 % vs 25.5 %) in LAG than that in OG, but the difference was not statistically significant (P = 0.088). The time to faltus (3.26 d vs. 4.49 d) and time to liquid diet (3.98 d vs.5.56 d) were significantly shorter in LAG than that in OG. Both the circumferential and distal margins were negative. The number of identified lymph nodes were similar for LAG and OG (mean 13.31 vs 13.13, P =0.886). Conclusion Laparoscopic-assisted rectal resection for elderly patients is safe and feasible, with less complications and blood loss, and rapid intestinal recovery compared with open surgery.

Objective To investigate the prognosis of local resection in patients with low rectal cancer, and assess surgical indications for this procedure. Methods One hundred and twenty-four patients with low rectal cancer from Jan 1975 to Dec 2006 were analyzed, the clinicopathologic features and surgical, outcome were examined as prognostic factors. Survival rate was estimated by Kaplan-Meier method and compared by Log-Rank test, prognostic factors were analyzed by multivariate COX proportional hazards model. Results The 5-year survival rate of 124 patients underwent local resection was 90.7 %(97/107), there were 4.8 %(6/124) patients with complications and 15.3 %(19/24) ones with local recurrence.The infiltration, vascular invasion, the size of tumor and the histological grade were significant prognostic factors of overall survival, but gender, age, the tumor site and the macroscopic type were not. Multivariate analysis indicated that the tumor infiltration were independent poor prognostic factor. Conclusion Local resection is suitable for Tis and T1 low rectal cancer, and those with high local recurrence factors should undergo radical resection. Strict follow-up and adjuvant therapy is necessary for local excision.

Objective To evaluate the value of the new ovarian function marker serum anti-Mullerian hormone (AMH)and to clarify the effect of hysterectomy on the ovarian function of the younger women.Methods The serum AMH,follicle stimulating hormone (FSH)and luteinizing hormone (LH)levels in 35 women suffered uterus benign lesion aged 36-45 years and 35 women suffered hysteromyoma without operation were measured at different time.And the ovarian arterial blood flow resistance index (RI ) was measured by Doppler ultrasound. Results Compred with before operation, the serum AMH levels of the patients in hysterectomy group 2 d and 3 months after operation were significantly decreased (P<0.05 or P<0.01).Compared with control group,the serum AMH levels of the patients in hysterectomy group 2 d and 3 months after operation were also decreased (P<0.05).The ovarian arterial blood flow RI of the patients in hysterectomy group 1 and 3 months after operation were increased compared with control group (P<0.05).There were no significant differences in the serum FSH and LH levels in each group between different time points (P>0.05).Conclusion Hysterectomy can affect the ovarian function,and the serum AMH level 3 months after operation is decreased and the ovarian arterial blood flow RI is increased.AMH is superior to FSH or LH in evaluating the changes of ovarian function.