Objectives To study the feasibility of total mesorectal excision (TME) by laparoscopy for rectal cancer.Methods The mesorectum in the resected samples and the number of lymph nodes resected were compared between laparoscopic (n=20) and open surgery group (n=20).Results ①The mesorecum of resected specimen was all complete in two groups. ②The lymph node yield (N 1) in laparoscopic and open group was 8.5?3.6 vs. 10.6?6.2(P=0.334), respectively. That in N 2 was 3.7?2.2 vs. 2.4?2.1(P=0.328). That in N 3 was 2.4?1.7 vs. 2.0?1.8(P=0.590).③The distal margin was all tumor-free in the two groups. ConclusionLaparoscopy is capable of performing TME in patients with rectal carcinoma undergoing radical resection.

Objective To investigate the drug resistance situation and clinical distribution of multi‐drug resistance Acinetobacter baumannii(MDRAB) ,in order to provide references for clinical treatment and prevention of MDRAB infection .Methods The de‐partments ,types of specimens ,time of infection ,gender and age of patients with Acinetobacter baumannii(AB)infection from Janu‐ary to December 2014 were retrospectively analysed ,and drug resistance rates of MDRAB were analysed as well .Results A total of 123 strains of MDRAB were isolated ,which accounted for 44 .73% of all strains of AB .The antibacterial resistance rates were over 90% for MDRAB against 12 out of 15 common antibacterial agents ,while the antibacterial resistance rate for MDRAB against mi‐nocycline was relatively low(19 .23% ) .Distribution of AB and MDRAB infection concentrated to certain departments ,which shown that intensive care unit(ICU) ,departments of respiratory medicine and neurosurgery were the major departments of infection .The strains of AB and MDRAB isolated from sputum specimens accounted for 84 .00% and 93 .50% respectively .There was no signifi‐cant differences of MDRAB infection among 12 Months in 2014 .There was no statistically significant differences in constituent ratio of MDRAB infection and non‐MDRAB infection between patients in different gender and between patients in different age groups . Conclusion MDRAB strains are seriously resistant to commonly used antibacterial agents ,while minocycline could still be a signifi‐cant antibacterial agent for clinical treatment of MDRAB infection .Strengthening infection management in ICU and departments of respiratory medicine and neurosurgery ,and infection management of respiratory tract and wound could have significance for reduc‐ing the risk of MDRAB infection .

Objective To evaluate risk factors for multidrug-resistant Acinetobacter baumannii (MDRAB)infec-tion,so as to provide reference for making preventive and control measures of MDRAB infection.Methods Clinical data of patients with Acinetobacter baumannii (A.baumannii )infection in a hospital between April 2011 and Sep-tember 2012 were surveyed,distribution and specimen sources of A.baumannii and MDRAB were analyzed,and risk factors of MDRAB were assessed.Results Of 236 isolates of A.baumannii,74 (31.36%)were MDRAB .The isolation rate of MDRAB in intensive care unit and neurosurgery department was up to 60.00%(27/45)and 58.06%(18/31)respectively;MDRAB were mainly isolated from wound (45.45%),respiratory tract (34.27%),and urinary tract (17.65%).Univariate analysis revealed that difference in length of hospital stay,use of serum albumin,fiberbronchoscopy, coma days,tracheotomy,use of ventilator,incisional drainage,urinary catheterization,use of carbapenems,and antimicro-bial days in different groups were statistically different (P <0.05).Multivariate logistic regression analysis revealed that tracheotomy(OR95%CI :1.152-7.187),use of ventilator(OR95%CI :1.263 -7.664)were independent risk factors for MDRAB infection.Conclusion Tracheotomy and use of ventilator play an important role in the producing and sprea-ding of MDRAB ,management on drug-resistant bacteria is important in reducing MDRAB infection.

Objective To study the reversal effect of tetrandrine (TET) on the multidrug resistance of Hep-2/ADM cell line and the possible mechanisms. Methods MTT method was used for the detection of the inhibitory effect of different concentrations of TET on the multidrug resistance of Hep-2/ADM cell line for selection of the non-toxicity concentration. MTT reduction assay was used to investigate the drug interaction of TET and vincristine (VCR) on HNE-1 (200) cell line. The reversal index (RI), accumulation and excretion of drug, and the apoptosis of Hep-2/ADM cell line were detected by flow cytometry. Results No toxicity to Hep-2/ADM cell line was found when TET concentration was lower than 1.5 ?g/ml. After interaction with TET (1.0 ?g/ml and 1.5 ?g/ml), RIs of VCR on Hep-2/ADM were 1.72 and 2.00 folds, respectively. TET at the concentration of 1.5 ?g/ml could increase the drug excretion and accumulation and also the apoptotic rate of VCR-induced Hep-2/ADM cell line. Conclusion TET can reverse the multidrug resistance of Hep-2/ADM cell line. The reversal effect may be related to the concentrations of TET. The possible mechanism may be that TET can increase the cell apoptosis of VCR-induced Hep-2/ADM cell line and can also increase the drug excretion and accumulation of the multidrug resistance cell line.

Objective To compare the effect of 5-fluorouridine(5-FUR) prodrug liposome on the cell proliferation and apoptosis in HEP-2 cells.Methods MTT assay was used to investigate the cell proliferation after 5-FU or 5-FUR prodrug liposome at the dose of 3.0,0.6,0.12 or 0.024 ?g/ml was added into the culture medium of HEP-2 cells for 72 h.Flow cytometry(FCM) was used to measure the cell cycle when the cells were treated with 0.17 ?g/ml 5-FU or 0.05 ?g/ml 5-FUR prodrug liposome for 72 h.The apoptosis of cells treated with 0.05 ?g/ml 5-FU or 5-FUR for 48 h were assayed with FCM.Results The IC50 of 5-FU on HEP-2 cells was 300% higher when compared with 5-FUR prodrug liposome.Treated with 5-FU and 5-FUR prodrug liposome respectively,HEP-2 cell lines were both arrested at S stage.the apoptosis rate of HEP-2 were(10.35?1.33)% and(21.57?0.11)% respectively.Conclusion Compared with 5-FU,5-FUR prodrug liposome inhibits the cell proliferation of HEP-2 cells more significantly,arrests more cells at S phase,and improves cell apoptosis.

Aim Toinvestigatetheinducementeffect of isatin on apoptosis of breast cancer cell line MCF-7 , andexploreitsdetailedmechanism.Methods MCF-7 cell lines were exposed to isatin at different concentra-tions(0,50,100,200 μmol·L-1 )for 48 h.Apop-totic features were demonstrated by nuclei staining with Hoechst 33258.Bcl-2,Bax and p53 mRNA were ana-lyzed by RT-PCR.Caspase-9 activation and mitochon-drial depolarization were assayed by flow cytometry. Bcl-2,Bax,p53 and cytochrome c proteins were ana-lyzedbyWesternblot.Results Isatininducesapopto-sis of MCF-7 cells.Furthermore,Bcl-2 expression was decreased and the ratio of Bcl-2 to Bax was significant-ly decreased by isatin.While,p53 expression relative-ly decreased.The mitochondrial transmembrane poten-tial was markedly reduced and the release of cyto-chrome c into the cytosol was increased after treatment with isatin.Simultaneously,caspase-9 was activated. Conclusions Isatinsignificantlyinducedtheapopto-sis of MCF-7 cells in vitro.These results strongly sug-gest that the p53 dependent mitochondrial pathway is involved in apoptosis.

Oncocytic lipoadenoma is a rare tumor, with only 18 cases having been reported since the first in 1998. We encountered a case of oncocytic lipoadenoma presenting as a slowly growing parotid mass in a 71-year-old man. This tumor is characteristically comprised of a mixture of oncocytes and adipocytes. The present case is one of five reported cases of oncocytic lipoadenoma showing sebaceous differentiation. The results of immunohistochemical study with DOG1 antibody supported the origination of this tumor in the striated duct.
Adipocytes ; Aged ; Humans ; Oxyphil Cells ; Parotid Gland*

Objective To compare the curative effect of conservative treatment and surgical treatment for bronchiectasis. Methods 60 patients with bronchiectasis were randomly divided into observation group and control group,30 cases in each group,they were treated with surgery and medical therapy respectively,the clinical efficacy,length of stay, costs, remission time of symptoms and signs, changes of blood gas index and ESR, CRP,TNF-α, WBC,NEUT of the two groups after treatment were compared. Results The curative rate of observation group was significandy higher than control group, while the length of stay, remission time of symptoms and signs and hospitalization costs were significantly lower than control group, the difference was statistically significant (all P ＜0.05) ;After treatmenit,the blood gas index of both groups improved significantly than before treatment(all P ＜ 0.05), and the blood gas index of observation group improved significantly than the control group (all P ＜ 0. 05); After treatment, ESR, CRP,TNF-α,WBC and NEUT of both groups were significantly decreased compared with those before treatment(all P ＜0. 05); Between the two groups, the index value of the observation group decreased significantly (all P ＜ 0.05).Conclusion Surgical treatment for bronchiectasis was superior to conservative treatment with better curative effect,lower cost, shorter hospital stay and faster relief of symptoms and signs, it had good prospects to be applied.

Objective To review the outcome of coronary artery bypass grafting (CABG) using left internal thoracic artery (LITA) grafts in these patients aged more than 70 years old.Methods 1471 patients aged more than 70 years old[mean (73.3 ± 3.9) years] from July 2010 through August 2012,who underwent CABG in Anzhen hospital,form the cohort of this study.Among them,1395 cases underwent off-pump CABG,while 76 cases underwent on-pump CABG which includes onpump beating heart CABG in 12 cases.The average number of the grafts is 3.12 ±0.68.All of the patients were divided into two groups on base of the graft:Group A:only saphenous vein graft was used in 564 cases; Group B:The left internal thoracic artery to the left anterior descending artery was used in 907 cases,which also include total arterial grafting,facilitated by the use of the radial artery,right gastroepiploic artery was operated in 42 cases,beside these artery grafts,saphenous vein graft was used to anastomosis with other vessels.Results Operative mortality was 2.12％ in group A and 2.09％ in group B.There was no significance between the 2 groups.The volume of blood drainage was larger in group B than that in group A.At the same time,there was no significance in the incidence rate of second thoractomy,malignant arrhythmia,stroke,poor wound healing,and usage of IABP between the 2 groups.Conclusion It did not increase the mortality and morbidity of serious complications using the left internal thoracic artery to the left anterior descending artery in those elderly patients aged more than 70 years old during the CABG operation.With consideration of the obvious advantages in the long term patency,LITA was proposed to be used in CABG even in those age ＞ 70 patients.

OBJECTIVETo investigate the clinical outcomes of the posterior C1,2 screw-rod combined with C2 unilateral translaminar screw and contralateral pedicle screw fixation and autogenous bicortical iliac crest graft fusion in treating upper cervical instability with vertebral artery variations.

METHODSFrom June 2008 to December 2012, the clinical data of 12 patients with upper cervical instability underwent C1 lateral mass screws-C2 unilateral laminar and contralateral pedicle screws fixation combined with autogenous bicortical iliac crest graft fusion were analyzed retrospectively. There were 8 males and 4 females with a mean age of 47.5 years (ranged, 16 to 77 years). Patients suffered from occipitocervical activity limitation of motion with pain or not, VAS was 0-7 points with an average of (3.50 +/- 2.71) points. Unilateral vertebral artery hypoplasia was demonstrated by vertebral arteriography (VAG) or CTA in all patients. Cervical X-ray and CT scans were done within 7 days after surgery in order to confirm internal fixation position. Internal fixation loosening and breakage, reduction losing, bone fusion ratio were observed during follow-up.

RESULTSNo nerves and vertebral artery injuries occurred during operation. Cervical pain obviously decreased and VAS was (0.92 +/- 0.90) points. Cervical alignment of 12 patients had well-recovered by X-ray while Atlantoaxial ventral lamina cortex of 1 case was encroached by CT scan without neurological symptom. All patients were followed up for 6 months to 3 years, no internal fixation loosening and breakage, reduction losing were found. All patients obtained bone fusion in 6-12 months after operation.

CONCLUSIONPosterior C1 lateral mass screws-C2 unilateral laminar and contralateral pedicle screws fixation combined with autogenous bicortical iliac crest graft fusion can achieve biomechanical stability and raise the successful rate of bone fusion, while avoiding the risk of vertebral artery injury and overcoming the insufficient of bone fusion during bilateral laminar screws placement as well. Posterior C1 lateral mass screws fixation is a safe and effective additional method in treating upper cervical instability with vertebral artery variations.

Adolescent ; Adult ; Aged ; Bone Screws ; Cervical Vertebrae ; surgery ; Female ; Humans ; Internal Fixators ; Joint Instability ; surgery ; Male ; Middle Aged ; Tomography, X-Ray Computed ; Vertebral Artery ; pathology