Objective The gross appearance and histopathology as well a s the treatment of early colorectal carcinoma were investigated. Methods The clinical documents and histopathology of 105 cases(106 lesions) with early color ectal carcinoma detected by colonoscopy and proved pathologically after operatio n in past 16 years were retrospectively reviewed and analysed. Results 91.5％ of the early colorectal carcinoma were located distal to the sigmoid.The macro scopic type of these lesions under colonoscopy was classified as Ip type in 34 l esions,Ips type in 13,Is type in 26,Ⅱ a type in 11,Ⅱ a＋Ⅱ c type in 22(in whi ch 21 lesions are Sm carcinoma).Lymph node involvement was observed in 3 cases o f the 25 with Sm carcinoma (accounting for 12％ ).13 lesions(in 12 cases)were re moved under the colonoscopy,local recurrence was found in one case of Sm carcino ma during the follow up period and treated with radical operation.93 lesions(in 93 cases)were treated by local resection or radical surgery. Conclusions Most of the carcinomas withⅡ a＋Ⅱ c type were sm carcinoma.Histopathologically mos t of Sm carcinomas were poorly or moderately differentiated adenocarcinomas.Lymp h node involvement only appeared in Sm carcinoma.Radical operation should be per formed in the following conditions (1)the macroscopic type isⅡ a＋Ⅱ c type,(2) the histopathologic type is poorly differentiated adenocarcinoma,(3)involvement of submucosa or lymph node metastasis

Objective To investigate the effect of patient-controlled intravenous analgesia (PCIA) with dexmedetomidine mixed with sufentanil on the sleep quality after spinal surgery.Methods Eighty patients of both sexes, aged 21-72 yr, weighing 48-100 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ , scheduled for elective spinal surgery, were randomly assigned into sufentanil group (group S) and dexmedetomidine mixed with sufentanil group (group DS) with 40 cases in each group.In group S, PCIA solution contained sufentanil 2 μg/kg and tropisetron 6 mg in 100 ml of normal saline.In group DS, PCIA solution contained sufentanil 2 μg/kg, dexmedetomidine 3 μg/kg and tropisetron 6 mg in 100 ml of normal saline.The PCA pump was set up with a 0.5 ml bolus dose, a 15 min lockout interval and background infusion at a rate of 2 ml/h.Sufentanil 5 μg injected intravenously and celecoxib 200 mg given orally were used as rescue analgesics, and numeric rating scale (NRS) score at rest was maintained ≤4 within 48 h after surgery.Ramsay sedation scores were recorded at 1, 2, 6, 12, 24 and 48 h after surgery.Sleep quality was evaluated using the Medical Outcomes Study Sleep Scale (MOS-SS), and the average time of daily sleep and Sleep Problems Index (SPI) were recorded at week 1 before and after surgery.Patient's satisfaction with sleep was assessed on the night of surgery and 1st day after surgery.The requirement for rescue analgesics was recorded.Results There was no significant difference in the requirement for rescue analgesics between group S and group DS (P＞0.05).Compared with the value before surgery, the average time of daily sleep was significantly shortened, and SPI was increased at week 1 after surgery in group S (P＜0.05 or 0.01), and no significant change was found in group DS (P＞0.05).Compared with group S, the Ramsay sedation scores were significantly increased at 1, 2, and 6 h after surgery, the average time of daily sleep was prolonged at week 1 after surgery, the SPI was decreased at week 1 after surgery, and the degree of satisfaction with sleep was increased on 1st day after surgery in group DS (P＜0.05 or 0.01).Conclusion PCIA with dexmedetomidine mixed with sufentanil is helpful in improving the sleep quality after spinal surgery in the patients.

Objective To explore the effect of psychotherapy in patients with methadone maintenance treatment.Methods 60 patients accepted drug and 69 patients accepted drug with psychotherapy treatment were evaluated with Self-Rating Anxiety Scale(SAS) and Self-rating Depression Scale(SDS) in the beginning of psychotherapy therapy and 3 months later.All of them were assessed for heroin use at 3 months after the end of a 3-month treatment period.Results SAS、SDS did not show any significant differences between the two groups in the beginning(P ＞0.05).After 3 months of psychotherapy,the differences in SDS and SAS between the two groups showed statistically significant(t =- 2.858,- 2.465,all P ＜0.05).After 2 months of psychotherapy,the number of relapsing again patients of group psychotherapy treatment was significantly lower than control group(x2 =6.906,5.054,5.100,4.247,all P ＜0.05).Conclusion The mental healthy status of patients with heroin dependence is poor.Psychological treatment plays an important role in short-term prevent hernoin addicts from relapse again.

Objective To analyze the anatomic changes and dosimetric variations of patients with head-and-neck cancer during intensity-modulated radiotherapy and to assess the necessity of re-planning the treatment course.Methods Twenty-one nasopharyngeal carcinoma patients were selected to receive the second CT scan in the course of intensity-modulated radiotherapy,targets and organs at risk were re-contoured on the new CT images with the help of deformable registration software.Actual dose distribution delivered by the original treatment plan was calculated on the second CT image,and then the volume and doses of targets and organs at risk were compared between the planning CT and second CT.Results The volume of patient's head-and-neck outlines and GTVnd decreased significantly,the volume of cord and brainstem didn't change much,while the volume of left and right parotids decreased significantly by (24.23 ± 12.15)％ and (25.82± 10.46)％,respectively.The parameters D95％ and Dmean of PGTVnx kept stable,but the parameters D1cc of spinal cord PRV and brainstem PRV increased by (8.12± 10.32)％ and (14.60±18.85)％ respectively.The mean dose of the left and right parotids increased significantly by (27.43±17.67)％ and (26.76±12.46)％,respectively.Conclusion The anatomical changes of patients undergoing intensity-modulated radiotherapy will cause significant dosimetric variations of the cord,brainstem and parotids,so it's meaningful and necessary to re-design the treatment plan in the course of radiotherapy.Repeat CT imaging and replanning during the course of IMRT is essential to ensure adequate doses to target volumes and safe doses to normal tissue.

In order to make students know about oral and maxillofacial surgery earlier in the current medical education model,which was important for fostering the professional interests of students,West China School of Stomatology,Sichuan University initiated freshmen into an introductory course in oral and maxillofacial surgery.The teaching methods are based on teaching and complemented byclinical intership.coure content including the history,present situation and development direction of oral and maxillofacial surgery.The course is popular among the students and the desired effect was achieved.

Objective:Whether extralevator abdominoperineal excision (ELAPE) improves survival and safety remains controversial.Systematic review of all comparative studies to define the superiority of ELAPE to conventional abdominoperineal excision (APE).Methods:Corresponding data,with case-control studies or cohorts regarding intraoperative perforation rate,the local recurrence rate and postoperative complications in the ELAPE group and the APE group,were retrieved from PubMed,Embase,the Cochrane Library,Chinese Biomedical Literature (CMB),VIP,China National Knowledge Infrastructure (CNKI),and Wanfang Database.Meta-analysis was performed by using RenMan 5.2.Results:A total of 10 articles were included.Intraperative perforation rate (MD=0.54,95％ CI 0.31 to 1.39,P=0.03),local recurrence rate (MD=0.30,95％ CI 0.21 to 0.42,P＜0.001) in the ELAPE group was significantly lower than that in the APE group.The difference in positive margin rate between the 2 groups was not statistically significant (P=0.07).Conclusion:Through gap repair of episiotomy and individualized therapy can improve ELAPE postoperative quality of life.ELAPE shows certain advantages in treating lower rectal cancer comparing to APE,but it should pay attention to individualized treatment.More studies through large sample multi-center,medium and long term randomized design are necessary to determine the effect of surgery on tumor.

Objective To discuss the feasibility of ultrasound in evaluating the effect of closed reduction with cast fixation on developmental dislocation of the hip.Methods Seventy-three cases with unilateral DDH treated by closed reduction with cast fixation under frog position were detected by ultrasound on the medial cross-section of the hips.The position relation between femoral head and acetabulum of the hips were demonstrated,the relevant parameters (the vertical distance between the femoral head and the central line through pubic symphysis) were measured and compared with the contralateral side to understand the situation of the femoral head.Results The contour of the femoral head and the ossification center can be visually displayed,the relative position relation of the femoral head and acetabulum can be demonstrated on the medial cross-section of the hip under frog position by ultrasound to judge the status of closed reduction.The measurement of the ultrasonic parameters can provide quantitative indicator for the status of reduction.Conclusions Ultrasound can be viewed as the first imaging tool to evaluate the effect of closed reduction with cast fixation on developmental dislocation of the hip for it is simple,intuitive and no radiation injury.

Hematologic Neoplasms ; diagnosis ; pathology ; Humans

Objective To compare the effects of 6MV and 10MV-X-ray intensity modulated radiotherapy (IMRT) on non-small-cell lung cancer (NSCLC) . Methods We randomly selected 20 patients with NSCLC, 6MV and 10MV X-ray were used respectively for each NSCLC patient with IMRT plan design, the ADAC Pinnacle 8.0f treatment planning system was applied to provide the convolution/iteration algorithm, for the same target IMRT plan design with two kinds of energy. By comparing the dose volume histogram (DVH),PTV parameter (Dmean, Dmin and Dmax), conformal index (CI) and homogeneity index (HI),we analyzed the metrology parameters . Results 6MV and 10MV radiation therapy plan DVH, PTV parameters,CI,HI and isodose line was similar,no statistically significant differences. But target dose homogeneity and the degree of target coverage in high dose of 6MV plan was better than that in 10MV plan. Endanger organs (OAR) such as normal lung tissue, heart, esophagus and spinal cord had basically same dose amount. Conclusion 6MV X-ray plan may be the better choice of radiotherapy on NSCLC.

ObjectiveTo observe the dose of methadone and the compliance of patients to the methadone maintenance treatment(MMT).MethodsWe analyzed the status of 69 patients who were addicted to opiate medication and 44 patients who dropped out in our clinic until July 31,2010.ResultsThere was no significant relationship between patients' urine test and the dose.Crime caused the patients who dropped out.The percentage of positive urine did not decline as the dose increased,but the rate of patients who dropped and the number of positive urine test showed a significant correlation( r =0.523 P =0.000).Crime was the main reason that affected the compliance to MMT and caused dropping out.ConclusionThe use of MMT dose should be individualized.