Objective To compare the safety and the long-term outcomes of laparoscopic and open radical resection for rectal cancer. Methods The clinical data of 602 patients who received radical resection at the Second Affiliated Hospital of Fujian Medical University from January 2000 to December 2008 were retrospectively analyzed.All patients were divided into the laparoscope group (324 patients) and the open group (278 patients).The numbers of dissected lymph nodes,lengths of proximal and distal resection margins,local recurrence rate,distal metastasis rate,overall survival rates and disease-free survival rates of the 2 groups were compared.All data were analyzed by the independent t test,chi-square test or Fisher exact probability. The survival rates were calculated by the life table method and were analyzed by the Wilcoxon (Gehan) test.Results The number of lymph nodes dissected in the laparoscope group and the open group were 21 ± 8 and 21 ± 9,with no significant difference between the 2 groups (t =1.120,P ＞0.05).The lengths of proximal resection margin were ( 15.1 ±1.3 )cm in the laparoscope group and (15.0 ±0.8)cm in the open group,with no significant difference between the2groups (t =1.452,P ＞0.05).The lengths of distal resection margin were (4.0 ± 1.6)cm in the laparoscope group and (3.3 ± 1.4) cm in the open group,with a significant difference between the 2 groups ( t =5.587,P ＜ 0.05 ).The overall local recurrence rate was 5.6％ (34/602),and no tumor recurrence was detected in the incision and port-site.The local reccurence rates were 6.2％ (20/324) in the laparoscope group and 5.0％(14/278) in the open group,with no significant difference between the 2 groups (x2 =0.363,P ＞ 0.05 ).The overall distal metastasis rate was 11.5％ (69/602),and the distal metastasis rates were 11.1％ (36/324) in the laparoscope group and 11.9％ (33/278) in the open group,with no significant difference between the 2 groups (x2 =0.085,P ＞0.05).The 3- and 5-year survival rates were 87.8％ and 83.0％ in the laparoscope group,and 84.9％ and 79.3％ in the open group,with no significant difference between the 2 groups (P ＞0.05).The 3- and 5-year tumor-free survival rates were 79.4％ and 69.2％ in the laparoscope group,and 79.7％ and 73.1％ in the open group,with no significant difference between the 2 groups ( P ＞ 0.05 ).The follow-up rate was 81.2％ (489/602).Forty-nine patients died,including 20 patients in the laparoscope group and 29 patients in the open group.Conclusion Laparoscopic radical resection for rectal cancer is reliable in the oncological efficacy,and is possible to achieve the similar long-term outcomes as that of open surgery.

Carbon fiber reinforced poly ether ether ketone (CF/PEEK) composite possesses excellent biocompatible, biomechanical and bioribological properties. It is one of the most promising implant materials for artificial joint. Many factors influence the bioribological properties of CF/PEEK composites. In this paper, the authors reviewed on the biotribology research progress of CF/PEEK composites. The influences of various factors such as lubricant, reinforcement surface modification, functional particles, friction counterpart and friction motion modes on the bio-tribological properties of CF/PEEK composites are discussed. Based on the recent research, the authors suggest that the further research should be focused on the synergistic effect of multiple factors on the wear and lubrication mechanism of CF/PEEK.
Biocompatible Materials ; Carbon ; Friction ; Ketones ; Lubrication ; Materials Testing ; Polyethylene Glycols

c-Jun N-terminal kinases(JNKs)play an integral role in neuronal death in multiple cell lines following a wide variety of stimuli and in a number of physiological functions which have been recognized as important enzymes in cellular function.JNK has been implicated in several neurodegenerative diseases.Data are emerging to extend the understanding of the JNK signaling and confirm the possibility that targeting JNK signaling may offer an effective therapy for pathological conditions in the near future.Because of the involvement of JNK in neuronal diseases,the inhibition of this enzyme is an attractive therapeutic target.

Objective To study the hypnotic interaction between propofol and ketamine with isobologram. Methods Seventy-five ASA Ⅰ - Ⅱ patients (35 male, 40 female) aged 20-50 yr, weighing 40-80 kg, undergoing elective upper abdominal surgery were randomly divided into three equal groups of 25 patients : propofol group (P); ketamine group (K) and propofol-ketamine combination group (P/K), Each group was further divided into 5 subgroups. Propofol 0.8, 1.0, 1.25, 1.56 or 1.95 mg ? kg-1 was given in 5 propofol subgroups (P1-5 ) respectively. Ketamine 0.32, 0.40, 0.50, 0.63 or 0.78 mg?kg-1 was given in 5 ketamine subgroups (K1-5 ) respectively. Propofol /ketamine 0.45/0.15, 0.60/0.20, 0.80/0.29, 1.05/0.35 or 1.41/0.47 mg?kg-1 were given in the 5 propofol-ketamine combination subgroups (P/K1-5 ) respectively. Two minutes after drug administration the patients were asked to open their eyes. Failure to open eyes was taken as the start-point of hypnotic effect. If the patient failed to respond to verbal order twice consecutively, the patient was considered to be in the hypnotic state. When the patient in hypnotic state failed to respond to electric stimulation of certain intensity, the patient was considered to be in anesthetic state. ED50s of propofol, ketamine and P/K combination for hypnotic and anesthetic effect were calculated. Isobologram was drawn. ED50 and 95 % confidence limit of ketamine were plotted on the abscissa and of propofol on the ordinate. The ED50 s of the two drugs were connected. If the ED50 of P/K combination was located on the connecting line, the two drugs are additive, on the left side of the connecting line synergistic, on the right side of the connecting line antagonistic. SBP, DBP, HR, SpO2 and BIS were continuously monitored before, during and after drug administration. Results The ED50 s for hypnotic and anesthetic effect were : 1.15 mg? kg-1 and 1.59 mg? kg-1 in group P; 0.40 mg? kg-1 and 0.72 mg? kg-1 in ketamine group; 0.65/0.22 mg?kg-1 and 1.19/0.40 mg?kg-1 in P/K group. The deviation of the location of ED50 of P/K combination from the connecting line was statistically insignificant. There was no significant change in SBP and DBF after administration of drugs in P/K group. Conclusion The hypnotic and anesthetic interaction between propofol and ketamine was additive. In terms of hemodynamic stability, P/K combination was the best among the three groups.

Background Corneal transplantation is an effective treatment to severe corneal diseases,but the shortage of cornea donor limits its application.Tissue-engineered cornea is being a new approach to corneal diseases.Objective This study was to investigate the possibility of construction of tissue-engineered corneal epithelium by culturing human amniotic mesenchymal stem cells (hAMSCs) in vitro.Methods Fresh human amniotic membranes were obtained under the approval of Ethic Committee of Affiliated First Hospital of Jinan University and informed consent of maternal women.The 6 cm×6 cm amniotic membrane tissue explant was digested using trypsin+ EDTA,and then the amniotic epithelial cells (AECs) were scraped before putting into collagenase Ⅱ digestion medium to isolate hAMSCs.hAMSCs of passage 3 were cultured to achive 80％-90％ confluence,and then the ceils were incubated on rabbit deepithelial corneal stroma at a 1 ×105/ml density.The corneal stroma was co-cuhured with hAMSCs at an air-liquid interface till 14 days.Rabbit deepithelial corneal stroma with and without hAMSCs (experimental group and control group) were fixed in 4％ para formaldehyde, and sections were prepared for histopathological examination.Immunochemistry and immunofluorescence were empoyed to detect the expressions of cytokeratin3 (CK3) and CK12 in hAMSCs.Results hAMSCs grew well and formed a stratified epidermal structure resembling native corneal epithelium on rabbit corneal stroma in cultured 14 days in the experimental group,with the oval nucleus at basement and fusiform nucleus on the surface of corneal stroma.There was no cell structure in the control group.Immunochemistry revealed brown staining for CK3, CK12 in cytoplasm of hAMSCs on the rabbits corneal stroma,and the green fluorescence for CK3 and CK12 was also seen in the hAMSCs.However,the response for CK3 and CK12 was absent in the control sections either immunochemistry or immunofluorescence test.Conclusions hAMSCs can be induced to differentiate into corneal epithelioid cells at an air-liquid interface on the rabbit corneal stroma.

Objective: This study explores the applicability of a multi-attribute decision-making method in assessing Guizhi Decoction (GZD) and its varieties as noted in the Shanghanlun. Methods: A known multi-attribute decision-making method, the analytic hierarchy process (AHP), was adopted to transform the clinical challenge of selecting optional decoction for a given combination of symptoms or signs into multiple criteria decision-making problem. Results: A normative model based on the AHP was realized for indications of GZD and its varieties. The indications of sub-family GZD-f (indications of GZD itself) were exterior illness; the indications of GZD-vf1 (indications of GZD's variants which consist of fine adjustments to the ingredients or content on the basis of GZD) were exterior illness with interior excess, suggesting that GZD-vf1 consisted of most conservative variants of GZD; the indications of both GZD-vf2 (indications of Guizhi Qu Shaoyao Decoction and its derivative variants) and GZD-vf3 (indications of Guizhi Gancao Decoction and its derivative variants) showed evolution from exterior illness to interior deficiency in 2 directions. As to efficacy evaluation of the decoction, GZD and its varieties (restricted to those comparable ones) were of equal efficacy on 3 popular signs or symptoms indicating exterior illness: floating pulse, aversion to wind and spontaneous sweating, which were the common ground of indications for the GZD family. Conclusion: Modeling of diagnostic procedure based on the AHP is proved practicable to analyze the clinical judgment system of traditional Chinese medicine. Quantification research on syndrome differentiation and decoction evaluation system focused on signs and symptoms is suggested as a feasible and reliable model.

With the common application of total mesorectal excision (TME) technique,the proportion of sphincterpreserving surgery for the mid-low rectal carcinoma is significantly increased.Anastomotic leakage after sphincter-preserving surgery is the most severe complication of rectal surgery,and it is the main reason which will lead to other complications and death.Many researches on the early diagnosis,prevention and treatment of anastomotic leakage are conducted by surgeons at home and abroad,and a further understanding of this complication is deeply realized.

Objective To study of manifestation of adenomyomatosis of gallbladder from MRI and to improve its accuracy of diagnosis .Methods MR features of 24 cases with adenomyomatosis of gallblad-der from 2006 to 2008 proved by operation and pathology were analysed retrospectively .Results Among 24 patients, 20 cases were diagnosed correctly before operation ,four were misdiagnosed as Chronic cholecysti-tis and carcinoma of gallbladder respectively; all cases of gallbladder wall increased thickness from 5 to 12mm (7mm average).Among them, the gallbladder -wall was thickened as limited type in fourteen cases , segment type in eight cases and diffuse type in two cases .And classical Rokitansky-Aschoff sinuses were clearly displayed in 20 cases by lamina T2WI from MRI .Conclusion MRI might has higher diagnostic value in diagnosing of adenomyomatosis of gallbladder .

Objective To evaluate the current status and outcomes of pelvic exenteration (PE) for recurrent cervical cancer.Methods The following electronic databases has been searched on recurrent cervical cancer management and treatment:Chinese Biological Medicine Disk (CBM),PubMed and Cochrane library.All retrieved studies had to fulfill the following inclusion criteria:cohort studies of recurrent cervical cancer,containing information of detailed patient and operation characteristics as well as the survival rate.Only publications in the English literature were included.All eligible literatures between Jan.1990 and Aug.2013 were assessed for quality.Relevant basic characteristics,complications,survival rate and prognostic factors were reviewed.Results There were eight trials involving 607 patients with cervical cancer received PE,including 515 cases with recurrent disease and 92 cases with primary disease.Four hundred and ninety patients had received total pelvic exenteration (TPE) operation,103 underwent anterior pelvic exenteration(APE) and 14 received posterior pelvic exenteration(PPE).The 5-year overall survival rate for recurrent cervical cancer fluctuate from 26.7％ to 56.0％.Complication rates were from 34.3％ to 83.3％ and the mortality rate was 1.2％ (7/607).Among the relevant factors affecting survival time,resection margin status seemed to be the most important.Conclusion Based on this systematic review,PE does help improve the survival of recurrent cervical cancer patients on the basis of strict selection of candidates.

By incorporation of tritiated thymidine or 5-bromodeoxyuridine and using them as the markers,we found that the basal cells,Clara cells and type II alveolar epithelial cells in the pulmonary tissues may in some way behave like stem cells and can eventually differentiate into respiratory tract epithelium.The slow progress of researches on pulmonary stem cells up to date has its root in the complex structure of pulmonary tissues and respiratory tracts,which is demonstrated by the facts that the respiratory system is composed of at least 40 types of cells,plus that the growth,renewal,and regeneration rate or capacity of respiratory epithelium are extremely limited.Mean while,there have been no specific stem cell markers for pulmonary and lung cancer,so researchers rely on stem cell markers borrowed from other systems to search for stem cells in pulmonary system.At present,the studies of lung stem cell markers were focused on Sca-1,ABCG2 /Bcrp1,cell retaining marker,surface marker,cell keratin and CCSP.Recently the lung stem cells have been shown to be the targets of transformation during lung carcinogenesis,which has provide more thoughts and direction for the occurrence and treatment of lung cancer.