Objective To explore the prevention and management of surgieal complications in Miles operation.Methods Retrospectively analyzed the main complications appeared in 176 patients of Miles operation.Results There was the eolostomy-related complications in 19 cases.Presacral venous plexus hemorrhage in 4 cases.Intestinal obstruction in 10 cases.Wound infection of perineum in 12 eases.Lesion of urinary tract in 1 case.The common complication rate of Miles operation was 26.1%.Conclusion Mastering operation skill and adherence to sound snrgical principles is the key to prevent and to decrease intra-postoperative complication.

Objective To evaluation the clinical implemented and primary experience of TME combined the double-stapling technique in low rectal carcinoma anus-preserving resection. Methods 22 cases of low rectal carcinoma (the distance between the inferior verge of rectal turnout and the anal verge were 4～7cm) were operated by TME combined the double-stapling technique. Results All of the 22 cases of TME combined double-stapling procedure were successful without operative mortality. Correlative complications including anastomotic leakage (3 cases), anastomotic stenosis (1 case). Temporary completely defunctioning loop colostomy 4 cases. Conclusions TME combined the double-stapling technique in low rectal carcinoma anus-preserving resection is feasibility and the tumour pathology and clinical stage should be considered. Mastering expert operation skill and adherence to sound surgical priciples is the key to prevent and to decrease postoperative complication.

China ; International Cooperation ; Occupational Health Services ; World Health Organization

Objective To study the change and significance of osteoprotegerin(OPG)/receptor activator of NF κB ligand(RANKL)during the process of rat arterial smooth muscle cells (SMC) to differentiate subgroups:7 d (early) subgroup and 14 d (late) subgroup.into osteoblast-like cells.Methods The rat arterial SMCs were divided randomly into the SMC group,atorvastatin group,and osteoblast-like group.Each group was also divided into 2.The osteoblast-like group was given β-glycerophosphate and vitamin C in culture medium,the atorvastatin group was given both β-glycerophosphate,vitamin C and atorvastatin.Von Kossa staining,Ca2+ content assay,ALP activity assay and osteocalcin assayed with Western blot were used to check the level of calcification.Real-time PCR was used to check the mRNA expressions of OPG and RANKL.Results There was high expression of OPG (early 2.71 ±0.08,late 2.69 ±0.02) but no RANKL in the SMC group all the time.The expressions of OPG were increased in the early subgroup and decreased in late subgroup in the atorvastatin group (early 3.52±0.05,late 2.50±0.03) and osteoblast-like group (early 4.18±0.10,late 2.30 ± 0.11).And the expressions of RANKL were both increased in the atorvastatin group and osteoblast-like group dnring the calcification process (from 1.01 ± 0.19 to 2.40 ± 0.10,and from 1.70±0.07 to 3.22±0.11,respectively).Among the three groups,the ratio of OPG/RANKL was decreased with the increasing calcification level (F =52.93,2.33,both P＜0.05).And compared with the early subgroups,the ratio of OPG/RANKL in the late subgroups was also decreased along with the increase of calcification level in each group(F=38.71,1.74,both P＜0.05).Conclusions The ratio of OPG/RANKL has a negative correlation with the level of the osteoblast-like cells differentiation,and atorvastatin could inhibit the calcification.

Objective To evaluate the relationship between femoral artery intima-media thickness (FA-IMT), stiffness, hemodynamics factors of femoral artery and peripheral vascular disease (PVD) in type 2 diabetes mellitus. Methods According to the presence of PVD, 151 patients with type 2 diabetes were divided into PVD group and non-PVD group. FA-IMT was tested with 2D ultrasound. Ds, Dd, PSV, EDV were observed with color flow rate and volume quantitative technology. FA-IMT, FA-stiffness β, peak systolic velocity (PSV) and end diastolic velocity (EDV) were compared between the two groups. Results Compared with non-PVD group, FA-IMT and FA-stiffness β increased in PVD group (P＜0.01), whereas PSV and EDV decreased in PVD group (P＜0.01). There was no relationship between FA-stiffness β and FA-IMT in PVD group (P=0.01). Multiple Logistic regression indicated the presence of PVD symptoms associated closely with FA-stiffness β, PSV, EDV and duration of diabetes. Conclusion Stiffness β plays an important role in the clinical evaluation of type 2 diabetes mellitus.

Humans ; Occupational Diseases ; prevention & control ; Occupational Health Services ; Sentinel Surveillance

Objective To explore the optimal dose-effect relationship of gene transfer according to the expression of pEGFP in tumor cells under different parameters mediated by microbubble contrast agent and ultrasound in vivo.Methods C57BL/6J mice were inoculated subcutaneously in the middle of the right flank with hepal-6 tumor cells.The mixture of SonoVue and enhanced green fluorescent protein(EGFP)plasmid was injected into the tail vein of each mouse, groups were randomly established according to different output intensity( 1 W/cm2, 2 W/cm2, 3 W/cm2 ), exposure time ( 1 min, 5 min, 10 min) and volume of SonoVue(30 μl,60 μl,90 μl), the expression of EGFP in tumor cells under different parameter was examined by flow cytometry and fluorescence microscopy.Results The expression of pEGFP in tumor cells was significantly higher with the increase of exposure time,output intensity and volume of SonoVue (1 min vs 5 min, P＜0.05; 1 W/cm2 vs 2 W/cm2, P＜0.05 ; 30/μl vs 60 μl, P＜0.05).However, the transfection efficiency of EGFP can not be enhanced continuously with the increasing exposure time,output intensity and volume of SonoVue (5 min vs 10 min, P＞0.05; 2 W/cm2 vs 3 W/cm2, P＞0.05; 60 μl vs 90 μl, P＞0.05).The highest transfection effieieney was achieved under intensities was 2 W/cm2 [(21.02±1.45)%]with 5 min[(23.22±1.91)%] exposed to ultrasound, and 60 /μl SonoVue [ (21.02±1.45) % ].Conclusions Gene transfeetion efficiency changded with the difference parameters.2 W/cm2,5 min and 60 μl SonoVue led to the optimum dose-effect relationship of gene transfer in vivo .

Objective To discuss the blood perfusion characteristic of benign and malignant gallbladder disease by contrast-enhanced ultrasound(CEUS).Methods The enhancement characteristic of 62 patients with occupying lesions in gallbladder were observed.Four case of cholecystolithiasis accompany biliary sludge were proven by surgery and remaining 58 case were confirmed by histopathological examination.Their enhancement time and enhancement pattern were analyzed.Results The Time-to peak of benign and malignant disease were (22.4± 4.0)s and (27.7± 2.6)s (t =5.756,P ＜0.01),the Time-to-hypoenhancement of benign and malignant disease were (58.0 ± 7.3)s and (41.5 ± 4.0)s (t =10.33,P ＜0.01),respectively.The peak intensity of benign and malignant disease were (19.2 ± 3.6)dB and (25.1 ± 2.9) dB (t =6.85,P ＜0.01),the mean transit time of benign and malignant disease were (22.72 ± 4.7)s and (6.3± 6.4)s (t =15.001,P ＜0.01),respectively.The destruction of the gallbladder wall of benign and malignant disease were 0％ (0/36) and 57.7％ (15/26) (x2 =25.05,P ＜ 0.01),the inhomogeneous enhancement of benign except biliary sludge and malignant disease were 43.8％ (14/32) and 57.7％ (15/26) (x2 =1.115,P =0.291,respectively).In early phase,78.1％ (25/32) and 80.8 ％ (21/26) of benign disease except biliary sludge and malignant showed hyperenhancement respectively(x2 =3.15,P =0.207).In later phase,84.4％ (27/32) and 76.9％ (20/26) of benign disease except biliary sludge and malignant showed hypoenhancement respectively(x2 =3.615,P =0.164).Conclusions CEUS can obtain the information of blood perfusion and make quantitatively analysis about the enhancement time.It also facilitate the diagnosis of solid occupying lesion in gallbladder.

Objective To assess the application of intraoperative transesophageal echocardiography for occluding the rupture of aortic sinus aneurysm ( RASA ) by cardiac interventional therapy via mini thoracotomy . Methods After anesthesia transesophageal echocardiography ( TEE ) was performed in patients with RASA to confirm or correct primary diagnosis from transthoracic echocardiography( TTE) and to predict the operative effect . During the operation the guide wire and Sheath pipe were accurately guided into rupture mouth of aortic sinus aneurysm by TEE . After the operation ,the position of closure and the function of aortic valve need to check carefully . Results Collection of 38 patients with aortic sinus aneurysm rupture ,20 patients who can be received interventional therapy were select by TEE . Sixteen patients accepted interventional treatment successfully ,including 8 cases with non‐coronary sinus tumor to break into the right atrium ,5 cases with non‐coronary sinus tumor to break into the right ventricle ,and 3 cases with right coronary sinus tumor to break into the right ventricular outflow tract ( 3 cases) . The patients who received intervention treatment successfully had stable vital signs ,and no obvious changes of heart cavity structure and cardiac function in normal . Postoperative multiple reexamination ,all patients showed the normal closure position ,aortic valve opening and closing movement . And no stenosis and reflux signal ,no residual shunt was detected . Conclusions TEE can confirm or correct primary diagnosis of TTE before the operation and guide the surgery operator to place the closure correctly during the operation and evaluate the effect of the treatment after the operation .

Objective To determine the content of heavy metals and harmful elements in commercially available Yuanhu Zhitong Capsule. Methods The determination of lead, cadmium, arsenic, mercury, copper and chromium by atomic absorption spectrometry and atomic fluorescence spectrometry was established.Results The recovery rate of the method was between 91.2% and 111.2%, and the precision of the experiment was less than 5%, and the range of each element was good.The stability and reproducibility of the method were good.Lead and cadmium and copper of Yuanhu zhitong capsule in different degree exceeded the standard, while the content of arsenic, mercury and chromium was in accordance with the requirements. Conclusion The method is simple and easy to operate, convenient and quick.The content of the current limit of Yuanhu zhitong capsule still need to establish the quality standard of lead and cadmium, arsenic, mercury, copper and chromium.In this paper, the establishment of the heavy metals and harmful elements determination method of Yuanhu zhitong capsule provide quality control and safety evaluation of reference.