Anastomotic leakage is a serious complication in colorectal surgery;The healing of intestine is still the hot spot of current research.Methods of estimating intestinal healing mainly include mechanical,biochemical,immunohistochemical and hitological Method.The estimating parameters mainly Comprise bursting pressure,breaking strength,the amount of collangen and matrix metalloproteinase(MMP),and the scale for histology.The measurement of collagen and MMP is the nost import ant index for estimating healing of intestinal anastomoses.Collagen is the most abundant extracellular matrix protein that determines the mechanical stability of the connective tissue during wound healing.Collagen degradation is usually the result of the synergistic action of several MMPs.

Objective To compare the healing ability differences between left colonic anastomosis and right colonic anastomosis in rats, in order to find a theoretical basis for the surgical management of colon resection. Methods Forty male Wistar rats were randomly divided into two groups: group A (end-to-end anastomosis of right colon, n=20), and group B (end-to-end anastomosis of left colon, n=20). Half of the rats in each group were sacrificed on the fourth day after operation, and the rest on the seventh day. The expressions of matrix metalloproteinase-1 (MMP-1), MMP-13 and collagen type Ⅰ were shown by immunohistochemical staining, and the histopathologic changes at the anastomosis were also demonstrated. Results The expression of MMP-1, MMP-13 at left colonic anastomosis was higher than that of MMP-1, MMP-13 at right colonic anastomosis, the expression of collagen type Ⅰ was lower than that of collagen type Ⅰ at right colonic anastomosis on the fourth day (P<0.05); The expression of MMP-1 at left colonic anastomosis was higher than that of MMP-1 at right colonic anastomosis, the expression of collagen type Ⅰ was lower than that of collagen type Ⅰ at right colonic anastomosis on the seventh day (P<0.05). Conclusions The healing ability of right colonic anastomosis is higher than that of left colonic anastomosis.

Ischemic cerebrovascular disease(ICVD) is temporary or permanent reduction of blood flow of the main arteries of the brain caused by cerebral transient,sudden,reversible neurological dysfunction.Timely recovery of blood supply to the brain is the most important way to save the patient's life,but at the same time gave restore blood perfusion brain tissue organs brought new damage,which is cerebeal ischemia reperfusion injury(CIRI).How to build an ideal,efficient,easy to operate brain ischemia-reperfusion injury in animal models to simulate the clinical study,and how to improve and innovate this model by researchers in recent years were reviewed in this article.

Ischemic cardiomyopathy (ICM) is due to coronary atherosclerosis cause long-term myocardial ischemia, make myocardial fibrosis diffuse, produce similar clinical syndrome like idiopathic dilated cardiomyopathy, which is one of a common clinical disease and causes increasing hazards to human health.Timely recovery of blood perfusion and coronary artery recanalization is one of the effective methods of treatment.However, it brings new damage while tissues and organs receive reperfusion, which is myocardial ischemia-reperfusion injury.In this paper, the current research progress in medicine myocardial ischemia-reperfusion injury and how to build a simple and efficient experimental animal models to mimic human myocardial ischemia-reperfusion injury were reviewed.

Objective To investigate the clinical typing and staging in diagnosis of Severe Acute Respiratory Syndrome (SARS). Methods Retrospective study was designed to analysis the principal clinical characteristic of SARS and the standard of clinical typing and staging was raised. Comparisons with X-ray in lung, change of lymphocyte subset, PaO_2, SaO_2,and prognosis of disease were performed. Results The standard of SARS clinical typing and staging is four types (light type, ordinary type, heavy type, serious type)and four phases (prodromal period, progres phase, fastigium, recovery phase). The light type is 8/162(4.9%), ordinary type is 69/162 (42.6%), heavy type is 41/162 (25.3%), serious type is (27.2%). Comparisons SARS clinical typing and staging with X-ray in lung, change of lymphocyte subset were found that the more lesion in lung, the lower lymphocyte and its subset, and more serious in clinical typing. Conclusions The standard of clinical typing and staging summarized basic clinical characteristic in SARS, and coincided with progress of SARS. The standard will be help of clinical diagnosis, treatment and judging the prognosis of SARS.

Objective To explore the methods in repairing the thenar wounds by microsurgical technique Methods Since 1989, thenar wounds were restored with transfer of superficial or deep palmar arch, recombine of thenar muscle flap Patch of nerve and transplantation of flap on 21 cases Results The thumb and flap were survived The two point discrimination was 5 to 10 mm The thenar muscle streugth reached MRC 4 with satisfactory oppones fuction Conclusion The thenal wounds cna be obtained good effect being repaired by microsurgical technique

Objective To examine the change of TGF-?1 in the bloods of rats which were induced by tetrachoride during the different times and to explain the mechanism of the change.MethodsThe experimental liver fibrosis induced by tetrachloride in rats was treated by matrine compound injection.Serum TGF-?1 and pathological changes in liver tissue were observed in control group,model group and therapy group during the time of the 4th,6th and 9th week.ResultsThere was an obvious change of TGF-?1 in the blood in different time and different groups.ConclusionMatrine compound injection has an antifibrogenetic action and TGF-?1 can reflect the change of liver fibrogenesis of different time as an index.

Objective To explore the development of pulmonary function of normal toddlers between 1 and 3 years old.Methods Totally 115 normal toddlers were divided into 2 groups according to their age,i.e,1 ～ 2 years old,2～3 years old.The indicator of small and big airway examine respiratory system static compliance,total airway resistance and functional residual volume were observed.Results No significant difference was found between male and female toddler( P ＞0.05 ).Between the two groups,the difference of respiratory rate was not significant( 27 vs 26,t =1.512,P ＞0.05 ).The values of tidal volumes in the 2 ～ 3 years group was notably higher than in the 1 ～ 2 years group(0.123 vs 0.091,t =8.586,P ＜ 0.01 ),but the values of tidal volumes per kilogram body weight was not significantly different (0.0091 vs 0.0087,t =1.958,P ＞ 0.05 ).The peak tidal expiratory flow in the elder group was similarly distinctly higher than that in the other group.The measured tidal breathing flow volume loops were both displayed uncharacteristic ellipse.The rations of inspiratory time to total respiratory time,the volume to reach peak tidal expira-tory flow to total expiratory volume,tidal expiratory flow at 25％ remaining expiration to peak expiratory flow and mid-tidal expiratory flow to mid-tidal inspiratory flow were not significantly different between two groups (P ＞ 0.05 ).Butthe ratio of peak tidal flow to tidal volume( 1.257 vs 1.095,t =2.099,P ＜ 0.05 ) and the respiratory system resistances( 2.698 vs 2.071,t =3.762,P ＜0.01 )were evidently lower in the elder group than in the younger.The respiratory system compliances(0.353 vs 0.254,t =4.296,P ＜0.01 ) and functional residual capacities(0.272 vs 0.212,t =8.469,P ＜0.01 ) were significantly higher in the elder group than that in the younger,but the values per kilogram body weight was not significantly different( P ＞0.05 ).It was shown that the values of tidal volume,peak tidal expiratory flow,respiratory system static compliance,residual volume were significantly different(0.0198 vs 0.0198,t =0.000,P ＞0.05),between two groups.The values of each parameter mentioned above were increased with age,and were positively correlated with body weight(γ=0.457,0.849,0.572,0.319 all P＜0.01 ).Conclusion Tidal breathing flow volume loop could show functions of small and large airways and partially replace the maximum expiratory flow loop.The parameters were stable in toddlers and could be used as reasonable index to evaluate the pulmonary function changes in pulmonary diseases.The ventilatory function,residual volume,respiratory system static compliance and peak tidal flow were increased with the age,which coincides with the rule of development of toddlers.

Objective To investigate the clinical features,diagnosis and treatment of medullary thyroid microcarcinoma (MTMC).Methods The clinical data of 14 patients with MTMC from Mar.2012 to Sep.2016 were retrospectively reviewed.All cases were treated with surgery and pathologically proved to be MTMC.Results All patients were sporadic MTMC.Calcitonin and CEA levels were measured before surgery in 11 patients.The median values were 81.61 (3.36-1187) pg/ml and 7.42 (0.81-90.75) ug/ml,respectively.All patients were followed up postoperatively.During a median follow-up of 24 months (8-63 months),no death happened.Regional lymph node metastasis occurred in 8 patients (57.14％),and lateral lymph node metastasis in 5 cases (35.71％).The rate of postoperative calcitonin abnormal was significantly higher in patients with lateral lymph node metastasis (P＜0.01).6 cases (42.86％) had abnormal postoperative calcitonin,among whom 5 cases had preoperative baseline calcitonin level higher than 100 pg/ml.Patients having abnormal postoperative calcitonin suffered from higher calcitonin and CEA baseline (P＜0.05).The tumor size was similar in two groups (P＞0.05).Conclusions For patients with thyroid nodules,preoperative screen of calcitonin can effectively detect MTC.Patients with elevated CEA also need to exclude the possibility of MTC.Compared with tumor size,calcitonin baseline is more important to surgical options and postoperative outcomes.Lateral lymph node metastasis,baseline calcitonin ＞100 pg/ml indicates abnormal postoperative calcitonin.

Objective To evaluate the role of cabon nanoparticles for dissecting lymph nodes and preserving parathyroid glans in patients with differentiated thyroid carcinoma undergoing total thyroidectomy plus bilateral central neck dissection.Metheds From Sep.2015 to Feb.2016,100 patients in Rui Jin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine with thyroid carcinoma undergoing primarily total thyroidectomy plus bilateral central neck dissection were randomly divided into carbon nonoparticle group and the contol group.The numbers of total dissected lymph nodes,the lymph node posterior to fight recurrent laryngeal nerve,metastasized lymph nodes,inadvertent parathyroidectomy,the parathyroid hormone and serum total calcium were measured.Results The average counts of lymph nodes in carbon nonoparticle group (10.96±5.43)were more than those in the control group at (8.22±4.40)lymph nodes,(t＝2.78,P＝0.01).The average counts of lymph node posterior to fight recurrent laryngeal nerve in carbon nonoparticle group (1.62±1.95)were more than those in the control group at (0.76±1.21)lymph nodes,(t＝2.66,P＝0.01).The numbers of metastasized lymph nodes was 2.02±2.40 in carbon nonoparticle group and 1.84±2.61 in the control group.The difference had no statistical significance(t＝0.36,P＞0.05).The amount of PTH and the decrease of PTH discrepancy one day after surgery between the two groups had no statistical difference (t＝0.23,P＞0.05),(t＝l.04,P＞0.05).The carbon nonoparticle group had 2％(1/50)mistakenly parathyroid gland removed incidence,on contrary,the control group had 6％(3/50)mistakenly removed incidence.The difference had no statistical significance(x2＝0.26,P＞0.05).Conclusion Carbon nonoparticle can improve the central lymph node detection rate,but the protection of the parathyroid glands is more likey to depend on the experience of the operator and the vascular protection.