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 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 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 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.

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.

?-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.

Objective To explore the correlation of B-type natriuretic peptide (BNP) with blood lipids and renal function in elderly patients with coronary heart disease (CHD).Methods According to the four quantiles of BNP level,325 subjects aged 65 years and over were divided into four groups:group A (≤32.4 ng/L),group B (32.5 ng/L),group C (62.4 ng/L),group D (＞ 162.5 ng/L).The left ventricular ejection fraction (LVEF),left ventricular end-diastole dimension (LVEDD),levels of blood lipids and renal function were compared among the groups.Results With the increase of BNP level,the LVEF was gradually decreased [(63.3±8.2) ％,(59.6±7.4) ％,(57.9±9.7)％,(55.2±10.6)％,respectively,F=11.54,P＜0.01] and the LVEDD was gradually increased (F=6.76,P＜0.01),the level of triglyceride (TG) was gradually decreased (F=2.73,P ＜0.05) in group A,B,C and D.Creatinine clearance was gradually decreased [(1.24±0.31) ml ·s-1 · 1.73 m-2,(1.21±0.31) ml· s-1 · 1.73 m-2,(1.24±0.29) ml · s-1 · 1.73 m 2,(1.09± 0.33) ml · s-1 · 1.73 m-2,respectively,F=3.62,P＜0.05],and blood urea nitrogen was gradually increased (F=4.43,P＜0.05) in group A,B,C and D.Multi-linear regression analysis showed that levels of total cholesterol,triglyceride,low density lipoprotein-cholesterol,high density lipoproteincholesterol,very low density lipoprotein-cholesterol,creatinine clearance and blood urea nitrogen were influencing factors for BNP (all P＜0.05).Conclusions BNP level can be used as a sensitive indicator for the diagnosis of heart failure and the assessment of its severity.The levels of blood lipids and renal function are associated with BNP.

Objective To observe the expression of aggrecanase 2 and a tissue inhibitor of metalloproteinase 3 (TIMP-3) in degenerate human lumbar intervertebral discs and their role in degeneration of the nucleus pulposus.Methods Pfirrmann classification was used to class degenerate intervertebral discs observed through MRI.They were divided into three groups:a control group (Pfirrmann grade Ⅰ-Ⅱ),a degeneration group (Pfirrmann grade Ⅲ-Ⅳ),and a severe degeneration group (Pfirrmann grade Ⅴ).A total of 45 cases accepted lumbar spine surgery for removing nucleus pulposus specimens.Each group contained 15 cases.After formalin-fixation and paraffin embedding,immunohistochemistry was used to detect aggrecanase 2 and TIMP-3 expression in the nucleus pulposus cells.Results The percentages of cells positive for aggrecanase 2 were (13.58 ± 7.76) ％,(33.48 ± 13.95) ％ and (56.00 ± 18.39) ％ in the control,degeneration and severe degeneration groups respectively.These differences had statistical significance.The percentages of cells positive for TIMP-3 were (34.78 ± 13.80) ％,(46.77 ± 10.98) ％ and (50.65 ± 16.45) ％,and these differences were again statistically significant.The aggrecanase 2/TIMP-3 ratios were also significantly different.Conclusion As the degree of degeneration of the nucleus pulposus increased,the expression of aggrecanase 2 and TIMP-3 rose,which indicates that both changes were closely connected with the degeneration.Their ratio was correlated with the degree of degeneration of the nucleus pulposus.

Objective To investigate the relationship between aggrecan and YKL-40 in knee articular cartilage of Sprague-Daw-lay(SD) rats with osteoarthritis (OA) .Methods Fifty-six healthy SD rats were randomly divided into 7 groups ,8 cases per group . The one side of knee joint was randomly selected for performing the anterior cruciate ligment transection (ACLT) and establishing the OA model .The rats in one group were randomly killed on the day of operation and at postoperative 0 ,2 ,4 ,8 ,12 ,16 ,20 weeks . The femoral condyle cartilage samples at different time periods in the operated side were collected for conducting safranin O /fast green staining and HE staining .Meanwhile ,the OA pathological grade was made out according to the modified Mankin scale .The expression of aggrecan and YKL-40 in the cartilage with different stages of OA were analyzed by the immunohistochemistry meth-od ,and the status of expression were measured by average optical density (AOD) .The correlation between aggrecan and YKL-40 was analyzed .Results With the aggravation of OA ,the expression of aggrecan was gradually reduced and the expression of YKL-40 was gradually increased .The differences during the early ,middle and late phases of OA had statistical significance (P<0 .05) . The expression of aggrecan was negatively correlated with the expression of YKL-40(P<0 .05) .Conclusion The level of aggrecan is gradually reduced with the aggravation of OA .Aggrecan is negatively correlated with the YKL-40 level ,which may reflect the dedifferentiation degree of joint chondrocyte to some extent .