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

Objective To evaluate the diagnostic value of positron emission tomography(PET) with the use of 18 F-fluorodeoxyglucose(FDG) in patients with gastic malignancy. Methods 18 F-FDG PET examination was performed for twenty three patients suspected to be suffering from gastric malignancy,and the results were evaluated against histopathological staging. Results The diagnostic accuracy of primary lesion by PET was 87.0%. When using a mean standard uptake value (SUVmear and SUVmax) with a cut-off of 2.5,the sensitivity was 86.2%(19/23)and 91.3%(21/23),respectively. The accuracy in identifying lymph node metastases and distant metastases by PET was 78.9%(15/19) and 7/8,respectively. Conclusion PET scanning is sensitive in the diagnosis of primary malignant lesion and metastatic lesion in patients suspected to have gastric cancer. It provides a valuable reference in the diagnostic evaluation,option of surgical strategy,and treatment in patients with gastric carcinoma.

Objective To study the changes in the endothelial reserve capacity to release tissue plasminogen activator (tPA) and nitric oxide (NO) and its relation to vasodilation and to diabetic angiopathy. Methods The capacity of vascular endothelium to release tPA and NO was examined by venous occlusion of the upper arm. Brachial artery diameter was measured at baseline, during postocclusion reactive hyperemia (flow-mediated endothelium-dependent), and after sublingual nitroglycerol administration (endothelium-independent), using a high resolution ultrasound technique in 15 control subjects and 23 patients with type 2 diabetes mellitus. Vasodilation was expressed as the percentage change relative to the baseline diameter, while endothelial tPA and NO release was expressed as the percentage change relative to the baseline tPA and NO levels. Thickness of the intima of carotid artery was measured using ultrasound imaging. Results There was no significant difference in endothelium-independent vasodilation between control subjects and diabetics. However, significant reductions in endothelium-dependent vasodilation (P

Objective To determine the distribution and antibiotics resistance characteristic of pathogens in urinary tract infections in aged female diabetics patients and provide scientific basis for clinicians in selecting effective antibiotics. Methods Pathogenic bacteria, isolated from specimens of 107 elderly female diabetic cases with urinary tract infections, were identified and drug susceptibility tests were performed by VITEK-32 analysator. Results Among all 107 kinds of isolated bacteria,the ratio of gram-negative bacteria was 74. 8% ( 80/107 ), predominated by Escherichiacoli ( accounting for 48. 6% [52/107] ); the ratio of gramposition bacterias was 13. 1% (14/107) and eumycetes was 12. 1% (13/107). In antibiotic resistance analysis,the gram negative bacteria showed higher drug-resistance to the some common-antibiotics, such as ampicililin,cefazolin,cefuroxime-sodium and cefuroxime axetil ( ＞ 70. 0% ), while they were sensitive to imipenem and amikacin( ＜ 10. 0% ). The gram positive bacteria were most sensitive to vancomycin (0%), followed by Linezolid(7.7% ). Conclusion Escherichiacoli were the major pathogenic bacteria in urinary tract infections in aged female diabetic patients, with higher drug resistance. Therefore, drug resistance monitoring should be carried out according to the variety of pathogenic bacteria so as to guide rational use of antibiotics and decrease drug resistance.

?-MSH is an endogenous neuropetide that is effective of all categories of expreimental inflammation. The mechanisms underlying the anti-inflammatory influence of ?-MSH are reviewed in the article. ?-MSH suppresses inflammation in the CNS and periphery by downregulating the activation of NF-?B, then inhibiting production of proinflammatory cytokines, nitric oxide, chemokines and adhension molecules, and increasing synthesis of anti-inflammatory cytokines. ?-MSH is useful in the treatment of many pathological situations in humans.

The diagnostic evidence on clinical diseases and theoretic basis of moving cupping therapy were ex- plored in the paper. By the observation of the local reaction, such as skin appearance and color, the affected location, duration of sickness and nature of disease were judged. Different moving cupping methods were selected for different disorders. It was discovered that the property of syndromes should be recognized by the palpation on skin and muscle in the moving cupping therapy so that the pathogenesis and treating principle could be carefully determined. The moving cupping therapy is the important component of body surface therapy. Skin reaction observation and syndrome differentiation is the essential guidance of the moving cupping therapy.
Acupuncture Points ; Acupuncture Therapy ; Humans ; Meridians ; Skin ; anatomy & histology ; blood supply

α-MSH is an endogenous neuropetide that is effective of all categories of expreimental inflammation. The mechanisms underlying the anti-inflammatory influence of α-MSH are reviewed in the article. α-MSH suppresses inflammation in the CNS and periphery by downregulating the activation of NF-κB, then inhibiting production of proinflammatory cytokines, nitric oxide, chemokines and adhension molecules, and increasing synthesis of anti-inflammatory cytokines. α-MSH is useful in the treatment of many pathological situations in humans.

Objective: This study investigates the biological effects and explores the molecular mechanisms of epigallocate-chin-3-gallate (EGCG) on the apoptosis of the human gastric cancer MGC-803 cells. Methods: After treatment with EGCG, cell apopto-sis was verified by flow cytometry with Annexin V and propidium iodide staining, DNA agarose gel electrophoresis, and transmission electron microscopy. The expression profiles of the apoptosis-related genes in the MGC-803 cells with or without treatment by EGCG for 12 h (100 μmol/L), was identified using SuperArray Human Apoptosis Gene Array. The upregulated Fas-L gene and down-regulated Bag-1 gene were confirmed by reverse transcription polymerase chain reaction (RT-PCR) and Western blot. Results: When the MGC-803 cells were treated with EGCG at 25, 50, 100, and 200 μmol/L for 24 h, evident sub-diploid peaks were observed. Under treat-ment with 100 μmol/L for 4, 8, 12, and 24 h, the number of early apoptotic cells was greatly increased. When the cells were treated with 100 μmol/L for 24 h, the DNA extracted from the cells displayed a characteristic ladder pattern with agarose gel electrophoresis. Typi-cal morphological changes were observed by electron microscopy, including cell shrinkage, karyo-pyknosis, and the formation of apop-totic bodies. The differential expressions of eight apoptosis-associated genes were determined by gene array detection. The results of Fas-L and Bag-1 selected for RT-PCR and Western blot were consistent with those of gene array. Conclusion: EGCG induces apoptosis in MGC-803 cells, which might be mediated by a number of specific genes and various signal transduction pathways.

BACKGROUND:There are stil about 10%-30%of patients presenting no obvious improvement of symptoms after lumbar disc herniation surgery, which are col ectively known as the lumbar spine post-surgery failure syndrome, and lumbar instability is one of the important reasons. OBJECTIVE:To evaluate the feasibility and efficacy of surgery including posterior lumbar spinal canal decompression, intervertebral disc resection, lumbar interbody fusion, and pedicle screw fixation on lumbar intervertebral disc protrusion concurring lumbar instability via MAST Quadrant retractor. METHODS:From December 2011 to October 2012, 62 cases of lumbar intervertebral disc protrusion concurring lumbar instability were treated with posterior lumbar spinal canal decompression, intervertebral disc resection, lumbar interbody fusion, and pedicle screw fixation via MAST Quadrant retractor. There were 38 female and 24 male ranging in age from 37 to 69 years (average 53.7 years). After operation, al patients were fol owed-up to evaluate the effect of the treatment. RESULTS AND CONCLUSION:The operative time was 90-210 minutes, average 145 minutes, and the amount of blood loss was 50-300 mL, average 120 mL. The hospitalization time was 5-9 days, average 6 days. Al incisions healed by first intention. Al patients were fol owed up 7.2 months on average (from 3 to 10 months). The preoperative JOA score was (10.25±2.34) points. The postoperative JOA score decreased to (18.31±3.12) points at the fol ow-up after 1 month and (25.35±2.61) points at the last fol ow-up, showing significant difference when compared with preoperative score (P<0.01). The preoperative VAS score was (8.24±1.15) points. The postoperative VAS score decreased to (2.97±1.12) points after 1 month and (1.13±0.39) points at the last fol ow-up, showing significant difference when compared with preoperative score (P<0.01). According to reforming Macnab standard, the results were excel ent in 53 cases and good in 9 cases at the last fol ow-up. The surgery including posterior lumbar spinal canal decompression, intervertebral disc resection, lumbar interbody fusion, and pedicle screw fixation via MAST Quadrant retractor is a safe, effective and minimal y invasive surgical technique in treating lumbar intervertebral disc protrusion concurring lumbar instability.

Objective To review the clinical experience of diagnosis and treatment of the congenital diaphragmatic hernia in newborn infants. Methods Thirty-three neonates were diagnosed having congenital diaphragmatic hernia in our hospital from Jan. 1,2004 to Sept. 30, 2009. The clinical data was retrospectively reviewed. Results 21 cases were treated surgically and 17 survived, while 4 cases died. The main cause of death was congenital pulmonary dysplasia. Another 12 cases refused to accept surgical treatment and they all died, one died shortly after he was born. Four cases who had been diagnosed by prenatal ultrasonography were survived. Conclusion The mortality of congenital diaphragmatic hernia in neonates was still high. Prenatal diagnosis of the congenital diaphragmatic hernia is very important and the cooperation between the obstetrics, neonatology and cardiothoracic surgery will improve the survival rate of congenital diaphragmatic hernia in newborn infants.