Complications related to CO2 pneumoperitoneum in laparoscopy surgery have led to the devel-opment of gasless laparoscopic surgery using abdominal wall lifting technique.The technique uses facilitate laparoseopic surgery without conventional pneumoperitoneum and markly reduced in the risks of anesthesiolo-gy,especially in old patients with cardiopulmonary insufficiency.The review summarizes the application of gasless laparoscopie surgery using abdominal wall lifting technique in the field of general surgery.

[Objective] To explore the curative effect of synthetic surgical therapy on severe flexion deformity knees.[Methods]There were 22 patients(35 knees)with flexion deformity knees who were treated by synthetic surgical therapy during March 1999 to February 2008.Evaluation with HSS scoring system at preoperative and postoperative period were made.[Results]All patients were followed up.The mean followed-up time was 3.1 years(range 13 months to 7 years).The mean HSS score of knee joint was 23.5 points at preoperative period(range-6 to 35)and it was 79.8 points at postoperative period(range 62~91).The result showed statistical significance(P

Lateral lymphatic drainage is one of the three important directions for low rectal cancer. Radical surgery of rectal cancer requires the dissection of lymph nodes along the drainage route which determines the extent of lymph node dissection. However, controversial arguments exist whether lateral lymph node belonging to the regional lymph node or the distant lymph node. This arguments has also brought the controversy about neoadjuvant chemoradiotherapy and lateral lymph node dissection, as well as the controversy about efficacy of neoadjuvant chemoradiotherapy on lateral metastatic lymph nodes. Combined with the preliminary clinical practices, the authors comprehensively analyze research advances at home and abroad, further elaborate the lateral lymph node metastasis of rectal cancer, the risk factors affecting lateral lymph node metastasis and tumor recurrence, and the evaluation of lateral lymph node by magnetic resonance imaging before and after chemoradiotherapy, et al, in order to investigate the selection and significance of lateral lymph node dissection in advanced low rectal cancer after neoadjuvant chemoradiotherapy.

Objective To test comparative effect of capecitabine and S-1 (Tegafur/gimeracil/oteracil) on advanced colorectal cancer.Methods 106 cases of advanced colorectal cancer in our hospital oncology were collected and randomly divided into 2 groups:capecitabine group (52 cases) and S-1 group (54 cases).The chemotherapy effect and adverse effect of 2 groups were collected.Results After one treatment period,3 cases of complete remission,19 cases of partial remission,15 cases of stable disease,15 cases of disease progression,efficient rate of 42.3％and control rate of 71.2％ were observed in capecitabine group.5 cases of complete remission,21cases of partial remission,19 cases of stable disease,9 cases of disease progression and efficient rate of 48.1％ and control rate of 83.3％ were observed in S-1 group.There were no significant differences in efficient rate,control rate adverse effect rate and survival time between 2 groups(P ＞ 0.05).Conclusion Capecitabine and S-1 are both safe and effective in treatment of advanced colorectal cancer.

Objective To evaluate the result of percutaneous internal fixation in treatment of uncomminuted ankle fractures (inner malleolus,extemal malleolus and ventral condyle). Methods A total of 26 patients with uncomminuted ankle fractures at age range of 20-55 years(mean 35.2 years)were treated with closed reduction and percutaneous internal fixation by screws,eannulated screws or Kirschuer pins under C-arm X-ray scan.All patients were followed up for 12-24 months(mean 14 months).Results All fractures were healed successfully.with healing time of 8-24 weeks(mean 10.3 weeks).According to Bourne Standard,excellent ankle function results were reposed in 15 patients,good in 9 and fair in 2,with excellence rate of 92%.There was no implant failure,postoperative infection or dehiscence. Conclusions With advantage of early rehabilitation and minor incision of the affected ankles,closed reduction and percutaneous internal fixation can be selected for transverse or oblique uncomminuted ankle fractures,especially for those patients with severe swelling or skin injury.

Objective To explore the effect of stroma cell-derived factor receptor CXCR4 on the homing of the hematopoietic stem/progenitor cells in utero transplantation. Methods CD34+ cells were collected by Ficoll density gradient centrifugation and MiniMACS and then stimulated for 48 h by SCF and IL-6 cytokines prior to transplantation. CD184(CXCR4) expressions and transmigrate rates of the CD34+ cells were analysed by flow cytometer. Cells pretreated with different treatment were transplanted into the abdominal cavity of the fetal BALB/c mouse in the pregnant days 13～14. Human CD45 cells as the marker of graft were detected by flow cytometry after 1 month the fetus born. Results Expression changes of CD184 on CD34+ cells were from 9.58%?1.56% to 19.32%?3.64% after SCF and IL-6 stimulation. The CD34+/CXCR4high cells exhibited significant increases in SDF-1 mediated chemotaxis compared with the CD34+/CXCR4low cells. Transmigration of CD34+/CXCR4high was inhibited by pretreatment with antiCXCR4mAb and PTX. The positive rates of human CD45 cells detected in the fetal mouse were significantly higher in the SCF and IL-6 pretreatment group. This effects were significantly abrogated after the addition of antiCXCR4mAbor PTX. Conclusion Up-regulation of CXCR4 expression may be useful for improving hematopoietic stem/progenitor cells homing in utero transplantation. This homing process is mediated and depends on the CXCR4 receptors. The signal transduction is mediated by PTX-sensitive Gi protein.

Objective To investigate the clinical and radiographic outcome of traumatic pubic symphyseal diastases fixed with the locked plate. Methods From December 2007 to December 2009,17 patients(11 males,6 females,at mean age of 45.3 years)with pubic symphysis diastasis of unstable pelvic ring injuries were treated with open reduction and fixation with the locked plate.According to Tile classification system,five patients were with type B1 fractures,one with type B2,one with type B3,six with type C1,three with type C2 and one with type C3.All operations were performed under general anesthesia.Pubic symphyseal diastasis was treated by open reduction and fixation with the locked plate.There were 13 patients with associated posterior pelvic disruption,of which seven patients were treated by open reduction via anterior approach and fixed wich the reconstruction plates,three by close reduction and fixed with percutaneoua sacroiliac cannulated screws and three by posterior approach and fixed with M type plates. Results Of all the patients,16 patients were followed up for a mean time of 16 months(6-30months),which showed mean blood loss of 200 ml(50-600 ml)and mean hospital stay of 21 days (14-62 days).The clinical outcome was measured according to Majeed scores system,which showed excellent results in seven patients,good in seven and fair in two. Conclusions The locked plate fixation takes advantages of sailsfactory clinical outcomes with less operative trauma and a lower implant failure and wound infection rate in treatment of traumatic pubis symphysis diastasis.Locked plate fixation of symphysis call be performed alone when the posterior pelvic ring is only partially disrupted (Tile B).Posterior fixation construction should be used if the pelvic ring is under complete instability(Tile C).

Objective To explore the effect of stroma cell-derived factor receptor CXCR4 on the homing of the hematopoietic stem/progenitor cells in utero transplantation. Methods CD34~+ cells were collected by Ficoil density gradient centrifugation and MiniMACS and then stimulated for 48 h by SCF and IL-6 cytokines prior to transplantation. CD184(CXCR4) expressions and transmigrate rates of the CD34~+ cells were analysed by flow cytometer. Cells pre-treated with different treatment were transplanted into the abdominal cavity of the fetal BALB/c mouse in the pregnant days 13～14. Human CD45 cells as the marker of graft were detected by flow cytometry after 1 month the fetus born. Results Expression changes of CD184 on CD34~+ cells were from 9. 58%±1. 56% to 19. 32%±3. 64% after SCF and IL-6 stimulation. The CD34~+/CXCR4~(high) cells exhibited significant increases in SDF-1 mediated chemotaxis compared with the CD34~+/CXCR4~(low) cells. Transmigration of CD34~+ /CXCR4~(high) was inhibited by pretreatment with an-tiCXCR4mAb and PTX. The positive rates of human CD45 cells detected in the fetal mouse were significantly higher in the SCF and IL-6 pretreatment group. This effects were significantly abrogated after the addition of antiCXCR4mAb or PTX. Conclusion Up-regulation of CXCR4 expression may be useful for improving hematopoietic stem/progenitor cells homing in utero transplantation. This homing process is mediated and depends on the CXCR4 receptors. The signal transduction is mediated by PTX-sensitive Gi protein.

Objective:To investigate the principle and measures of prevention and treatment on pancreatic fistula due to pancreatic injury.Method:The clinical data of 131 pancreatic injury patients were analyzed retrospectively.Operation and combined therapy during perioperative were performed.Results:Among 35 cases(26.7%,35/131) with pancreatic fistula,3 cases shaped internal fistula showed by visualization and cured spontaneously after operations,9 cases with pancreatic pseudocyst after operations were treated by Roux-en-Y pancreatic cystojejunostomy,2 cases(5.7%,2/35) died of MODS and abdominal infections.The rest were recovered.The follow-up from 3 months to 5 years showed that there were no cases died of complications related to pancreatic fistula.Conclusions:Operation combined with multiple therapies was effective in the prevention and treatment of pancreatic fistula.

Objective To investigate the correlation between methylation status of UNC 5C gene promoter with colorectal cancer UNC5C .Methods 54 cases of sporadic colorectal cancer and related normal mucosal tissue ,as well as 6 colon cancer cell lines and fiber cell lines(FCL) in the oncology department of the Kailuan General Hospital from February 2010 to March 2013 were selected as the research objects and performed the mRNA and methylation analysis for exploring the correlation between the netrin‐1 receptor UNC5C defects with colorectal cancer disease .Results mRNA of UNC5A and UNC5B was expressed in the detected colorectal cancer cell lines .Except FCL for UNC5C ,all of the cancer cell lines had no mRNA expression .In colorectal cancer tissue , UNC5C methylation was significantly higher than that in the normal mucosa ,the difference was statistically significant (P<0 .05) . The methylation levels of UNC5C gene in the stage Ⅰ to Ⅱ ,and the stage Ⅲ to Ⅳwere significantly higher than non‐methylation levels ,the differences were statistically significant (P<0 .05) .The correlation analysis by the Spearman method showed that the UNC5C defects was positively correlated with colorectal cancer disease (r= 0 .856 ,P< 0 .05) .Conclusion Netrin‐1 receptor UNC5C defect has certain correlation with colorectal cancer disease .