Digestive tract reconstruction is the main part of gastrointestinal surgery. With the rapid development of technology and widely application in stapling device, more and more surgeons are using stapled anastomosis. Stapled anastomosis is associated with shorter operating time and hospital stay than hand-sewn anastomosis. However, it is not easy to select suitable ones from various staplers and use them correctly. Choice and reasonable application of staplers for anastomosis in gastrointestinal surgery are summarized and evaluated in this article.
Anastomosis, Surgical ; instrumentation ; Digestive System Surgical Procedures ; instrumentation ; Humans ; Surgical Staplers

The latest developments of techniques that prolong the half-life of protein drugs were reviewed.The therapeutic potential of several proteins is limited by their rapid clearance from the body,resulting in the need for frequent treatment of individuals to maintain drug levels.Several techniques including chemical modification,protein fusion,microsphere,glycosylation,and protease-resistant variants,and so on,prevent rapid degradation of such drugs and prolong their half-lives in vivo.Several successful protein drugs with prolonged half-life have already been on the market or on clinical trials.The principles,efficiencies and scopes of application of these techniques were described,compared and discussed.

OBJECTIVE:To find out potential financial risk in the listed Chinese pharmaceutical companies and to provide rec-ommendations. METHODS:The Z-score established with Altman E was adopted to classiy and analyzed empirically 143 listed phar-maceutical companies in China during 1998-2013 by sub-sectors(medical devices,pharmaceutical commercial,biological products chemical raw medicine,traditional TCM). The effects of some data in annual reports on Z-score were validated by using stepwise regression. RESULTS:The result showed that the average Z-score values percentage of the best 3 companies were 90.95%,47.96%and 41.25%,respectively,from 1998-2013;while for the worst 3 companies,the values were 0.80%,1.14%and 1.21%,respective-ly. At the same time,the financial situations of chemical raw medicine companies were the worst among 5 sub-sectors,of which dur-ing 2004-2006,the constituent ratios of companies in“Distress”zones went over 50.00%,which were 60.00%,55.20% and 53.60%,respectively. If counted by calendar year,the market value per share of 10 years and float of 9 years significantly affected the Z-score values(P<0.05);if counted by listed year,the market value per share of 15 years significantly affected the Z-score val-ues. CONCLUSIONS:Although major pharmaceutical companies have good financial status,financial crisis still exists in some companies. Especially,the financial situations of chemical raw medicine companies should not be neglected. The government should pay more attention to share price in order to prevent financial crisis which was induced by stock bubbles;at the same time,supervi-sion system should be established to evaluate the financial situation of listed pharmaceutical companies,even for all listed companies.

A questionnaire survey was conducted in 724 students from three junior high schools in Shanghai Jinshan district.Total 642 students completed the questionnaire with a response rate of 88.7％,among them 75 were overweighted or obese.The positive rate of 6 out 8 unhealthy psycho-behavioral practices related to weight control in overweight or obese students was significantly higher than that of students with normal weight (all P ＜ 0.05).Binary logistic backward stepwise regression analysis showed that overweight or obesity was risk factor for the unhealthy psycho-behavior practices related to weight control in adolescent students.

Objective　To study the expressions of oncogenes c-Ha-ras, c-ki-ras, pan-ras and c-myc and point mutation of c-Ha-ras1 during hepatocarcinogenesis in rats. Methods　Immunohistochemistry, in situ hybridization and microdissection of tissue (MDT)-PCR-SSCP were used to detect the oncogene expressions and point mutation of c-Ha-ras1 in both Solt-Farber model and DEN-induced liver cancer model. Results　The overexpression of c-Ha-ras was closely associated with the formation and proliferation of the precancerous basophilic hepatocyte foci, while that of c-myc with the growth of the oval cell foci. The abnormalities of IGF-Ⅱ played an important role in the evolution of precancerous foci/nodules towards hepatocellular carcinoma (HCC). The overexpression of fms was only associated with HCC of some rats. Conclusion　Hepatocarcinogenesis in rats was related with the overexpression of c-Ha-ras, c-myc, IGF-Ⅱand fms and the point mutation of c-Ha-ras1, and overexpression of these oncogenes was associated with morphological evolution.

Objective　To explore the relationship between morphologic evolution and proliferative activity during hepatocarcinogenesis in rats. Methods　Imaging analysis technique was used to detect the morphologic parameters of cells in hepatic lesions in both Solt-Farber model and diethylnitrosamine (DEN)-induced liver cancer model. Immunohistochemistry was employed to detect proliferating cell nuclear antigen (PCNA) and bromodeoxyuridine (BrdU). Results　The oval cells were identified as irregular small proliferating cells in size of one-eighth of and with a nucleus/cytoplasm ratio of 6 times of the normal hepatocyte by image analysis. The morphometric parameters of basophil hepatocyte in precancerous foci and nodule were similar to those of the liver cancer cell. PCNA and BrdU positive cells were mainly localized within the proliferative foci and hepatocellular carcinoma (HCC) tissues. There was a better consistency between the development of hepatic lesions and cellular proliferative activity. Conclusion　The morphologic evolution is closely related to proliferative activity during hepatocarcinogenesis in rats.

Objective To observe the effects and significance of Nordy on the expression of vascular endothelial growth factor (VEGF) and inducible nitric oxide synthase (iNOS) in the retinas of diabetic rats. Methods Diabetic rats by streptozotocin were randomly divided into diabetes group (5 rats?2) and Nordy treatment group (5 rats?2). Another 10 normal rats were recruited as normal control group. The Nordy treatment group was injected 0.5% Nordy (27 mg/kg) while diabetes groups and normal control group were injected saline solution into peritoneal cavity once every other day. One month or 3 months later, 5 rats in each group were killed and the expression of VEGF and iNOS in the retinas were detected by immunohisochemistry. The average positive areas were measured and analyzed by computer aided video system. Results The expression of VEGF and iNOS in control group were extremely low. In 1 month, the expression of VEGF and iNOS in diabetic group increased and the average positive areas of VEGF and iNOS were significantly more than that of Nordy treatment group (P

Thirty-six cases of astrocytoma (10 cases each of gradeⅠ and grade Ⅱ,and eight cases each of grade Ⅲ and grade Ⅳ) with definite followup data were studied with microspec-trophotometry on Feulgen stained slides to determine the nuclear area and the DNA content.10 specimens of normal brain tissue or brain tissue with gliosis were observed with the same technique.It was found that there was no significant difference of the nuclear size between the cells of grade Ⅰ astrocytoma and those with gliosis,but the DNA content was significantly higher in the former than in the latter.And there was also defference of the histograms between the 2.The higher the grading of astrocytoma,the larger the nuclear area,and the higher the DNA content.The peak values of the histograms were shifted rightward with a scattering of the values.In addition,along with the increase of DNA index,there was a decline of the survival curve of the patients with an obvious shortening of the survival time.The findings suggest that nuclear DNA quantitation can serve as an auxiliary tool to differentiate grade.I astrocytoma from gliosis,to grade astrocytomas and to predict the prognosis.

Objective To evaluate the reliability of transversus abdominis muscles measure with ultrasonography. Methods The thickness of bilateral transversus abdominis muscles of 20 volunteers at rest and during different postures for training was measured with ultrasonography by 2 examiners. The rate of contraction was calculated. Results The measurement was correlated strongly between examiners (r>0.7). There was significant difference in variety of thickness among postures except head rise to contralateral leg rise (P<0.01). Conclusion Ultrasonography is reliable in measuring transversus abdominis muscles.