Objective To investigate the surgical techniques and clinical efficacy of laparoscopic intersphincteric resection (ISR) in the treatment of low rectal cancer.Methods A retrospective descriptive study was performed.The clinical data of 12 patients who underwent laparoscopic low rectal anterior resection combined with ISR at the First Affiliated Hospital of Dalian Medical University from May 2014 to October 2014 were collected.The patients underwent abdominal operation including total mesorectal excision (TME) + sphincter mobilization,then transanal intersphincteric resection,finally colinic anal-anal anastomosis.The operation time,volume of intraoperative blood loss,number of lymph node dissected,postoperative complications,time to anal exsufflation,duration of hospital stay,duration of postoperative hospital stay,pathological stage and follow-up were observed.The patients were followed up by outpatient examination and telephone interview at month 1,3 and 6 after operation up to April 18,2015.The follow-up included the prognosis of patients and the recovery of anal function.The function of defecation was evaluated by Wexner scoring system and Kirwan grading.Measurement data with normal distribution were presented as (x) ± s.Results All the 12 patients were completed laparoscopic surgery without conversion to open surgery.Eight patients underwent partial internal anal sphincter resection,and 4 underwent subtotal resection.Four patients in T3 stage underwent lateral lymph node dissection preserving the left colonic artery,hypogastric nerve and pelvic nerve.The operation time was (290 ± 35) minutes.The volume of intraoperative blood loss was (124 ± 80) mL.The number of lymph nodes dissected was 17 ± 8,and the number of positive lymph nodes was 0-4.The distance of the distal margin was (2.0 ± 0.5) crm,and the margin was negative.All the 12 patients were not complicated with infection,bleeding,anastomotic leakage,anastomotic stenosis and other complications.The time to postoperative anal exsufflation was (3 ± 1)days,duration of hospital stay was (20 ± 3) days,and duration of postoperative hospital stay was (12 ± 3) days.The results of TNM stage showed 3 cases of pT1 stage,5 cases of pT2 stage,4 cases of pT3 stage,10 cases of pN0 stage,1 case of pN1 stage,1 case of pN2 stage,8 cases of Ⅰ stage,2 cases of Ⅱ stage and 2 cases of Ⅲ stage.All the 12 patients were followed up for 6-11 months.The defection frequency and the Wexner score at month 1,3 and 6 after operation were 12 ±7,15 ±3,9 ±5 and 13 ±4,5 ±3,10 ±3,respectively.Of the 12 patients,the number of patients with satisfactory Kirwan score,flatus incontinence and loose stool was 1,3,8 at month 1 after operation,3,3,6 at month 3 after operation,10,2,0 at month 6 alter operation,respectively.Conclusion Laparoscopic ISR is effective in the treatment of low rectal cancer.

Reduced surgery for early gastric cancer has been actively performed because it can offer complete cure and a good postoperative quality of life.Pylorus-and vagus-preserving gastrectomy (PPG) is one form of function-preserving surgery.Laparoscopic surgery has been widely applied for the treatment of gastric cancer due to its advantages including low invasiveness,minimal bowel paralysis,earlier postoperative healing and nerve and gastric function preservation.Therefore,laparoscopic pylorus-and vagus-preserving gastrectomy (LAPPG) for the treatment of early gastric cancer is welcomed by surgeons.From May 2004 to April 2013,12 patients with early gastric cancer received LAPPG in the First Affiliated Hospital of Dalian Medical University.All the patients were followed up for 3-74 months.One patient died of gastric cancer liver metastasis at postoperative month 22.The 5-year cumulative survival rate was 86％.LAPPG preserves nerve function and limits surgical injury,it is one of the ideal surgical methods for the treatment of early gastric cancer.

With the support of World Bank ( WB ) and UK Department for International Development ( DFID) , China Rural Health Project ( hereinafter referred as Health XI Project) began to introduce the idea of performance management to 40 counties in 8 provinces in 2008 . The project implemented cyclic performance manage-ment strategies, including performance planning, performance communication, performance evaluation and perform-ance improvement. With the continuous improvement of performance as the goal, the project attempted to establish incentive mechanisms based on the performance of health care services. After five years of pilots in 40 counties, it has achieved good results in the aspects of improving the quality and efficiency of health care services, motivating the enthusiasm of health care managers and workers, etc. Moreover, it has successfully built several advanced counties with exemplary performance management and accumulated some experience, which provides reference and demonstra-tion for implementing performance management in other areas. The key experiences of implementing performance management of rural primary health care include taking health care quality as the core of performance, appropriately combining economic and non-economic incentives, encouraging personnel participation in performance management in order to ensure the sustainability of performance improvement, and effectively applying the ideology of systematic per-formance management in order to effectively enhance the management level of hospitals. The paper also puts forward some policy suggestions based on emerging issues during implementation of performance management.

Objective To investigate the dose-effect relationship of donor antigenic specificity CD4~+ CD25~+ Treg cells prolonging the survival of rat kidney allograft.Methods Sixty allograft kid- ney transplantation animal models were established with SD rats as donors and Wistar rats as recipi- ents.CD4~+ CD25~+ T cells were sorted from Wistar rats'spleens by way of MACS and the phenotypes of donor antigenic specificity were induced in vitro.According to the quantities of prepared CD4~+ CD25~+ T cells injected through tail vein in kidney transplantation,models were divided into four ex- perimental groups:2?10~5(group I),5?10~5(groupⅡ),1?10~6(groupⅢ),2?10~6(groupⅣ).The models which had no injection served as control group(n=12).The survival of the transplanted kid- ney was observed.The levels of blood serum creatinine were determined and the histopathological changes in the transplanted kidney were observed at day 4,9 and 15.The results of histopathology were evaluated according to the standard of Banff Schema and the semi-quantitative scores were gained by way of Watanabe.The reaction indexes of receptor spleen cells to the donor antigens were tested by way of MTT at day 15.Results The mean survival time of transplanted kidneys was the highest in groupⅢ[(31.4?4.6)days]and lowest in the control group[(11.7?6.2)days].There was signif- icant difference between groupⅢand control group in levels of serum cre'atinine(P

Objective: Enteral nutrition was used to correct the malnutrition in the patients suffered from esophageal rupture postoperatively. Methods: The naso intestinal tube was placed during operation and the enteral nutrition was used postoperatively. The albumin, prealbumin and transferrin were measured before and day1, 5, 8 and 12 after operation. Results: All 27 patients were discharged with no death. Albumin, prealbumin and transferrin decreased on the 1st day postoperatively and reached the preoperative level on the fifth postoperativeday. Conclusion: Enteral nutrition plays an important role in the postoperative treatment for esophageal rupture.

ObjectiveTo explore the renal functions of vasopressin-deficient Brattleboro(BB) rats by using different concentrated Gadolinium-diethylenetetramine pentaacetic acid(Gd-DTPA) dynamic enhanced magnetic resonance imaging(MRI).MethodsThe study included 14 BB rats(male rats of 3 month-old) and 14 normal male Wistar rats used as control group.Dynamic MRI was performed by using either a low dosage(0.05 mmol/kg) or a high dosage of Gd-DTPA(0.5 mmol/kg).Data of 0-60 min renal cortex,medulla and pelvic were obtained after using contrast medium.MRI of kidneys at different time was analyzed and the mean relative signal intensity(RSI) was measured.Then the RSI curves of different groups were marked.Data of each group were caculated separately by SPSS 11.0 software.ResultsThe findings demonstrated that RSI curves of the vasopressin-deficient kidneys showed different patterns as compared with those of the control group(P

Objective:To analyze and summarize the commonalities and patterns in acupoint selection for moxibustion treatment of asthma. Methods: Data retrieval was conducted using ‘moxibustion’ and ‘asthma’ as the keywords through China National Knowledge Infrastructure (CNKI), Wanfang Academic Journal Full-text Database (Wanfang) and Chongqing VIP Database (CQVIP). Excel 2010 was used to establish the major acupoint database for moxibustion prescriptions in treatment of asthma; data mining methods including association patterns and clustering were adopted to analyze the characteristics and patterns in acupoint selection for moxibustion treatment of asthma. Results: A total of 161 moxibustion prescriptions were recruited. The most commonly used acupoint was Feishu (BL 13), the most commonly used meridian was the Bladder Meridian of Foot Taiyang, and the most commonly treated region was the back. The association rule analysis showed that Feishu (BL 13)-Dazhui (GV 14)-Fengmen (BL 12) had the most significant correlation, and the clustering analysis discovered 5 effective acupoint clusters. Conclusion: In moxibustion treatment of asthma, topical acupoints Feishu (BL 13), Dazhui (GV 14) and Fengmen (BL 12) can be selected, along with the acupoints from the Bladder Meridian of Foot Taiyang and the back.

Objective To investigate cognitive impairment mechanism by studying dorsolateral prefrontal cortex connectivity in patients with primary insomnia.Methods Forty patients with primary insomnia and 50 healthy subjects from the Department of Neurology,People's Hospital of Zhengzhou University during the period April 2011 through April 2013 were included.The World Health OrganizationUniversity of California Los Angeles Auditory Verbal Learning Test (WHO-UCLA AVLT) and the digital pin test were applied to evaluate the subjects' word study ability and vigilance.Resting state functional magnetic resonance imaging was used to observe the connectivity of dorsolateral prefrontal cortex.Results The Pittsburgh Sleep Quality Index (2.00 (1.00,3.00)) and the Hamilton Anxiety Scale scores (13.00 (11.25,15.75)) of primary insomnia patients were significantly higher than that of healthy controls (11.00(9.00,13.00),1.00 (0,2.00),Z=-5.517,Z=-5.525,P＜0.01).Digital pin test efficiency (60.03％ ± 13.95％ vs 66.32％ ± 13.73％,t =2.142,P＜0.05) and WHO-UCLA word learning (10.11 ± 2.29 vs 11.95 ± 2.42,t =-3.493,P ＜ 0.01) of primary insomnia patients were significantly lower than that of healthy controls.Compared to the healthy controls,the right dorsolateral prefrontal cortex of primary insomnia patients exhibited decreased functional connectivity of the right prefrontal lobe (-2.610 3 ± 0.172 6,t =-3.504,P ＜ 0.05).The left dorsolateral prefrontal cortex of primary insomnia patients exhibited increased functional connectivity of the bilateral insular lobes and right prefrontal lobe (2.8204±0.326 5,2.371 7 ±0.106 6,2.492 6 ±0.052 8,t =4.032,t =3.340,t =3.037,P ＜0.05).Conclusions The ability of WHO-UCLA word study and the digital pin test efficiency have been shown to decline in patients with primary insomnia.The possible mechanism of cognitive impairment may be the abnormal dorsolateral prefrontal cortex connectivity in patients with primary insomnia.

Saccharomyces cerevisiae strains may have some defects in beer production.Purposeful alteration of metabolic pathway with molecular biology techniques after analysis the metabolic fluxes has been a main way of S.cerevisiae breeding.The researchers have done a lot of work on some aspects of S.cerevisiae,such as the substrate utilization,maneuverability,reducing the no use by-products,improve the beer flavor,and got many delightful results,all of this are summarized here.

Object To optimize the process for the recovery of soyasaponins from bean product waste. Methods Conditions for the recovery were studied by orthogonal design guided by the yield of soya-saponins as determined by UV absorbance. Results The most influential factor in the recovery by refluxing was the concentration of alcohol; while in the recovery by percolation the influential factors were in the order of concentration of ethyl alcohol, amount of alcohol used and the rate of percolation.Conclusion The optimal recovery process was found to be a single reflux with eight times of 60% alcohol for 2.5 h.