Objective To investigate the clinical outcomes of transanal local excision (LE) and transabdominal radical surgery (RS) for T1 rectal cancer with distance from anal verge (DAV) ≤ 8.0 cm,and analyze the prognostic factors after non-palliative resection of T1 rectal cancer with DAV ≤8.0 cm.Methods Theretrospective cohort study was conducted.The clinicopathological data of 82 T1 rectal cancer patients with DAV ≤8.0 cm who were admitted to the Fujian Medical University Union Hospital between December 2000 and December 2014 were collected.Among 82 patients,42 undergoing transanal LE and 40 undergoing transabdominal RS were allocated into the LS and RS groups,respectively.Forty-two patients in the LE group received transabdominal RS or postoperative adjuvant radiochemotherapy if results of postoperative pathological examination showed high risk.Observation indicators:(1) comparisons of surgical and postoperative situations between the 2 groups;(2) followup situations;(3) prognostic factors analysis after non-palliative resection of T1 rectal cancer with DAV ≤ 8.0 cm.Follow-up using outpatient examination and telephone interview was performed to detect the defecation and sexual functions,survival and tumor recurrence up to January 2017.Measurement data with normal distribution were represented as (x)±s,and comparisons between groups were evaluated with an independent sample t test.Comparisons of count data were analyzed using the chi-square test or Fisher exact probability.The Kaplan Meier method was used for calculating overall survival rate and tumor-free rate,and survival was analyzed using the Logrank test.Multivariate analysis was done using the COX regression model.Results (1) Comparisons of surgical and postoperative situations between the 2 groups:all the 82 patients underwent successful surgery.Of 42 patients in the LE group,28 underwent single transanal LE,2 underwent additional transabdominal RS within 1 month postoperatively,6 underwent postoperative adjuvant radiochemotherapy,5 underwent postoperative adjuvant radiotherapy and 1 underwent postoperative adjuvant chemotherapy (didn't complete course due to poor tolerance).Forty patients in the RS group underwent transabdominal anterior resection of rectum or combined with abdominal perineal resection for rectal cancer.DAV,operation time,volume of intraoperative blood loss,time of postoperative gastrointestinal function recovery,cases with pulmonary infection and duration of postoperative hospital stay were (4.9±1.3)cm,(65±33) minutes,(11±7)mL,(1.2±0.4) days,0,(2.2±0.9)days in the LEgroupand (6.7±1.9)cm,(256±35)minutes,(65±47) mL,(2.4±0.8)days,6,(6.9±1.1) days in the RS group,respectively,with statistically significant differences (t =4.882,12.448,3.553,4.025,x2 =6.797,t =10.367,P＜0.05).Cases with intraperitoneal infection,wound infection,urinary tract infection,inflammatory intestinal obstruction,anastomotic fistula,chyle leakage,rectovaginal fistula and positive surgical margin were 0,0,0,0,0,0,0,1 in the LE group and 1,0,0,1,0,2,l,0 in the RS group,respectively,with no statistically significant differences between the 2 groups (x2 =1.063,1.063,2.153,1.063,P＞0.05).All patients with complications were cured by conservative treatment.(2) Follow-up situations:of 82 patients,67were followed up for defecation function (37 in the LE group and 30 in the RS group),40 were followed up for sexual function (25 in the LE group and 15 in the RS group),76 were followed up for survival.Follow-up time was 1-145 months,with a median time of 31 months.Cases with fecal incontinence and sexual dysfunction were respectively 0,0 in the LE group and 4,3 in the RS group,showing statistically significant differences (x2 =5.247,5.405,P＜0.05).Cases with 5-year local recurrence,5-year overall survival rate and 5-year tumor-free survival rate were respectively 1,94.1％,91.0％ in the LE group and 0,87.6％,87.6％ in the RS group,showing no statistically significant differences (x2 =0.833,2.313,0.849,P＞0.05).(3) Prognostic factors analysis after non-palliative resection of T1 rectal cancer with DAV ≤ 8.0 cm:results of multivariate analysis showed that age was an independent factor affecting prognosis of T1 rectal cancer patients with DAV ≤8.0 cm after non-palliative resection (RR =1.254,95％ confidence interval:1.055-1.491,P＜0.05).Conclusions Transanal LE in treatment of T1 rectal cancer patients with DAV ≤ 8.0 cm is consistent with RS in local control and long term prognosis,and the protection of defecation and sexual functions in LE is superior to that in RS.Age is an independent factor affecting prognosis of T1 rectal cancer patients with DAV ≤ 8.0 cm after non-palliative resection.

Objective To investigate the difference of neuromuscular blocking effect of cis-atracurium under sevoflurane anesthesia between the genders. Methods 30 ASA Ⅰ or Ⅱ patients aged from 18 to 45 years who scheduled for laparoscopic operation were divided into two groups, male group( M group, n = 15 ) and female group ( F group,n = 15). After induction of Anesthesia all cases were maintained with remifentanyl 3μg/L(TCI) and sevoflurane.After 40 minutes of stable end-tidal anaesthetic concentration, a total dose of cisatracurium 45 μg/kg was divided into 3 equal doses( 15μ g/kg each) ,which was administered accumulatively in each patient. The next dose was given when the effect of the previous dose had reached its peak ( T1 was no longer depressed in the height of 3 successive stimuli).Neuromuscular block was monitored using accelograph(TOF GUARD,Denmark). The onset time and maximum depression of T1 of the initial dose and 2 incremental doses were recorded. The cumulative dose-response curves of the two groups were established. The effective dose to obtain 50% and 95% neuromuscular block( ED5o and ED95 ,respectively) were calculated from individual dose-response curves. After the lastincrement of 15 μg/kg, the time for T1 to return to 25% ,50% ,75% and TOF ratio(T4/T1 )to 70% were recorded. The recovery index( RI)was also calculated.Results The mean ED5o and ED95(95% confidence interval)of cisatracurium of women were 22.2( 15.8 ～27.2)and 38.4 ( 32.1 ～ 54.4) μg/kg during sevoflurane (1.3MAC) anaesthesia, while the data of men were 25.6 ( 19.7 ～30.8) μg/kg and 42.8 ( 36.3 ～ 58.2 ) μg/kg, the difference between groups had no statistical significance ( P ＞0. 05). There was no significant difference in the TOF ratio ( T4/T1 ) to 70% and recovery index between the two groups( P ＞0.05 ). The onset time of F group was shorter than M group. The time for T1 to return to 25% ,50% and TOFR 0.7 was significantly longer in the F group than in the M group (P ＜ 0.05). Conclusion The neuromuscular blocking effect of cis-atracurium under 1.3MAC sevoflurane anesthesia remained no difference between genders. But the onset time of women was much faster. Furthermore the effect on the time for T1 to return to 25% ,50% and TOFR 0.7 were greater than men.

Objective patients with pSS and 30 cases of healthv contrels.The streptavidin immunohistochemical staining was performed to detect the expression and distribution of MMP-9 and CD147 in labial salivary glands.Quantitative analysis was performed by image analysis software-image plus 5.0 at the site of positive expression of MMP-9 and CD147.The correlation between their expression and the infiltrating lymphocyte foci per 4 mm2 of labial gland was analyzed by SPSS software as well as the correlation between the expression of MMP-9 and CD 147 in the salivary glands of patients with pSS.Results MMP-9 was hiKhly expressed in labial salivary glands from 52 patients with pSS and 30 healthy controls,but the expression of MMP-9 in pSS was stronger compared with that of healthy controls(P<0.01).There was a significant positive correlation between lymphocyte foci score and up-regulated expression of MMP-9 in labial salivary glands from 52 patients with pSS(P<0.01).CD147 was highly expressed in labial salivary glands from 52 patients with pSS and 23 healthy controls，but over-expression of CD147 in PSS was more Drominent compared with that of controls(P<0.01).There was a significant positive correlation between lymphocyte foci score and up-regulated expression of CD147 in labial salivary glands from 52 patients with pSS(P<0.01).The expression of MMP-9 and CDl47 was detected in ductal and acinar epithelial cells,lymphocyte foci in pSS.There was linear correlation between the expression of MMP-9 and CDl47 in the salivary glands of patients with pSS(P<0.01).Conclusion The results of this study suggest that the abnormal expression of MMP-9 and CD 147 is involved in the pathogenesis of pSS and play a crucial role.The interaction of MMP-9 and CD147 may be one of theimportant mechanisms leading to labial salivary glands destruction found in pSS.

Objective To analyze the clinical efficacy of balloon occlusion of distal abdominal aorta for patients with pernicious placenta previa and placenta accreta.Methods Data of 72 patients with pernicious placenta previa and placenta accreta were retrospectively analyzed.There were 53 cases (occlusion group) reserved balloon occlusion in abdominal aorta before cesarean section,which can temporarily blocked abdominal aortic blood flow during operation.The other 19 cases (non-occlusion group) underwent cesarean section without balloon occlusion of abdominal aorta.The intraoperative,post operative situations and the birth state of newborn of the two groups were compared.Results The bleeding,blood transfusion and hysterectomy rate during the operation in occlusion group were less than those in non-occlusion group (all P＜ 0.05).Differences of the rate of postoperative transferring to intensive care unit (ICU) and the time in ICU were statistically significant between two groups (both P ＜0.05).No statistical difference of operation time,postoperative total hospital stay time and the rate of postoperative infection was found between two groups (both P＞0.05).There was no statistical difference of newborns weight and Apgar scores (5 min and 10 min after birth) between two groups (all P＞0.05).Conclusion The balloon occlusion of distal abdominal aorta in cesarean section for patients with pernicious placenta previa and placenta accreta is safe and feasible,which can effectively reduce the intraoperative bleeding,the blood transfusion and the risk of hysterectomy.

Objective To explore the associations between polymorphisms in CYP24A1 gene and the risk and prognosis of colorectal cancer ( CRC) .Methods A case-control study consisting of 528 CRC patients and 605 cancer free controls and a follow up study with 317 cases were conducted to explore the associations be-tween two polymorphisms in CYP24A1 and the risk and prognosis of CRC,as well as the combinations and inter-actions of polymorphisms with dietary factors on CRC risk.Results Although there was no association between polymorphisms in CYP24A1 and the risk of CRC,significant combinative effects between polymorphisms and diet-ary factors on CRC risk were observed.For Rs4809957 polymorphism,the prognosis of AA genotype carriers was worse than GG/GA carriers in CRC,colon cancer and rectal cancer(Log-rank test P=0.01,P=0.01,P=0.02,respectively).Compared with GG genotype,AA genotype carriers of Rs4809957 polymorphism had worse prognosis in CRC(HR =2.35,95%CI =1.28~4.30),colon caner(HR =2.37,95% CI =1.09~5.14) and rectal cancer(HR =2.11,95% CI =1.11~4.01).Conclusion The combinations of the polymorphisms in CYP24A1 gene with dietary factors are associated with the susceptibility of CRC,and Rs4809957 polymorphism may lead to a worse prognosis of CRC.

Aim Series of compounds,which were considered to be the antagonists of ET-1 receptor,were synthesized by Beijing Institute of Pharmacology and Toxicology.The biological activity of these compounds was screened and some active compounds were selected for further pharmacological characterization on pulmonary hypertension.Methods Radioligand binding assay was performed to study the binding affinity of compounds for ETA and ETB receptors.The biological activity of compounds was evaluated in isolated rat aortic ring and in systemic arterial pressure(SAP)of anesthetized rat experiments.In addition,hypotensive effect of compounds was investigated on monocrotaline induced pulmonary hypertension in rats.Results Compounds bind to ETA receptor had over 10 000 fold higher affinity than to ETB receptor.Contraction induced by ET-1 in isolated rat aortic ring was inhibited by compounds,and 1 ?mol?L-1 ETP-508 shifted the cumulative concentration-contraction response curve to ET-1 to right with no change in the maximal response.In vivo,the increase in SAP induced by ET-1 〔3.7 ?g?(0.5 ml)-1?kg-1〕 was inhibited by 2 mg?kg-1 compounds by intravenous infusion.Furthermore,BQ-485 and ETP-508 by intravenous infusion(0.4 mg?h-1)significantly inhibited 80 mg?kg-1(sc)monocrotaline induced pulmonary hypertension in rats.Conclusions These results indicate that ETP-508 and BQ-485 are highly selective ETA receptor antagonists and significantly inhibite monocrotaline induced pulmonary hypertension in rats.

Ojective To study the pathological changes of testis tissue in SARS patients.Methods Tissue specimens were studied by HE staining、TUNEL and immunohistochemistry(IHC).Results SARS patients showed that widespead germ cells destruction,few or no spermatozoon in the seminiferous epithelium and the lumen,thickened basement membrane、 peritubular fibrosis、 vascular congestion and leukocytes infiltration.The apoptotic seminiferous cells increased significantly(P

AIM: To seek a small interfering RNA ( siRNA ) sequence targeting rat inhibitor of nuclear factor kappa Bα ( IκBα) that can specifically and effectively suppress IκBα mRNA expression of rat ciliary muscles in vivo.METHODS:Three IκBα specific double stranded siRNAs were designed and synthesized. They were transfected into rat A7r5 cells which express IκBα gene. Flow cytometry was used to assess transfected efficiency. The mRNA and protein levels of IκBα were examined by Real Time quantitative polymerase chain reaction ( Real Time-PCR ) and western blot to screen a candidate valid sequence with the highest inhibitory rate. The Cy3 labeled non-specific control siRNA or the candidate valid siRNA was then injected into rat anterior chamber. Distribution of Cy3- siRNA in rat ciliary muscles was viewed by fluorescence microscopy, and the inhibitory effect in vivo of the valid siRNA was identified via Real Time-PCR and immunofluorescence. RESULTS: The suppression effect of the siRNA targeting the CTACGATGACTGTGTGTTT of IκBα gene was most obvious by vitro screening. By anterior chamber injection, this valid siRNA could reach rat ciliary muscles and effectively suppress IκBα gene expression with the highest inhibitory rate of 59. 0% on mRNA level at 24h after RNAi, and 52. 3% on protein level at 72h after RNAi (P<0. 01).CONCLUSION: It proves that the siRNA targeting the CTACGATGACTGTGTGTTT of IκBα gene is the valid sequence to suppress rat IκBα expression of ciliary muscles by RNAi in vivo.

Abstract: Objective　The study aims to investigate the diagnosis quality and accuracy of syphilis cases reported by medical facilities in Inner Mongolia, understand possible problems and influencing factors in reporting and diagnosis, providing evidence for the better formulation of syphilis control and prevention. Methods　Cross-sectional survey was conducted with 2 counties sampled randomly from 12 municipals of Inner Mongolia, different medical facilities were covered. Syphilis cases reported from July 2019 to June 2020 in medical institutions of different categories were sampled and checked. The quality and accuracy of syphilis case reporting were evaluated according to the identifiers in "Syphilis Diagnosis (WS 273-2018)" and "National STD Case Reporting Quality Management Scheme (2018)". In addition, the basic information of medical institutions and the implementation of syphilis detection in laboratories were investigated, and the physicians who reported the case first were interviewed to understand their mastery of syphilis diagnosis and reporting, thus analyzing the major factors influencing the accuracy of reports. Results　The reporting rate of syphilis in medical institutions in Inner Mongolia was 99.04% (311/314), the missing-report rate was 0.96% (3/314), the timely reporting rate was 98.05% (1 659/1 692), the completeness rate was 99.64% (1 686/1 692), the correct rate was 99.35% (1 681/1 692), the accuracy rate of internet-based input was 84.63% (1 432/1 692). There were statistical differences in the quality (&chi;2=13.95, P<0.05; &chi;2=11.40, P<0.05) and accuracy （&chi;2=30.06, P<0.05; &chi;2=44.93, P<0.05) of reports among different municipals and different types of medical facilities. The accuracy rate of syphilis reporting by medical institutions was 86.17% (1 458/1 692), the correct rate for classifying diagnosis was 87.06% (1 473/1 692), and the accuracy rate of staging was 90.25% (1 527/1 692). Multivariate logistic regression results showed that whether the first-clinic physician attended training in the past three years [OR=6.26, 95%CI: (2.12-18.46)] and whether they grasped the key points of syphilis classification standard [OR=2.79, 95%CI: (1.21-6.46)] influenced report accuracy. Conclusions　The quality of reports in Inner Mongolia medical institutions is generally high, but the accuracy rate of reporting and correctness of network input have not yet reached the target requirement of 95%. There is still room for improvement in reporting and diagnostic capabilities. It is suggested to further strengthen the training frequency and coverage for physicians on syphilis diagnosis standard.

OBJECTIVETo investigate of the value of monitoring of saturation of blood oxygen of the injured extremity on prevention of osteofascial compartmental syndrome.

METHODSTwenty patients of osteofascial compartmental syndrome included 13 male and 7 female with an average age of 32 years ranging from 13 to 60. There were 13 cases of tibial and fibual fractures, 3 cases of tibial plateau fractures, 4 cases of femoral shaft fractures. SpO2 on the end of injured extremities were dynamic monitored and osteofascial compartmental pressure was measured by modified Whiteside method. The data of two group were compared.

RESULTSAmong 20 cases, it's negative correlation between the data of pulse blood oxygen saturation and osteofascial compartmental pressure.

CONCLUSIONThe method of dynamic monitor extremity SpO2 can reflect indirectly the ischemia in muscle and nerve and report the early diagnosis and management of osteofascial compartmental syndrome.

Adolescent ; Adult ; Compartment Syndromes ; blood ; diagnosis ; metabolism ; physiopathology ; Female ; Heart Rate ; physiology ; Humans ; Ischemia ; metabolism ; physiopathology ; Male ; Middle Aged ; Muscles ; metabolism ; Nerve Tissue ; metabolism ; Oximetry ; methods ; Oxygen ; blood ; Regional Blood Flow ; physiology ; Young Adult