Objective To discuss causes and prevention of complications and recurrence following sphincter preserving procedure(SPP) for rectal cancer.Methods A retrospective study on clinical and follow-up data of 375 cases of rectal cancer treated by SPP from January 2000 to January 2006 was carried out.Factors relating complications and recurrence after the operation were analyzed with the Logistic regression.Results A follow-up was conducted for 1～60 months(mean,37 months).The 5-year survival rate was 75.77%,and 79 cases of those followed died.Postoperative complications included anastomotic leakage in 14 cases(3.73%),anastomotic stenosis in 37 cases(9.87%),and anastomotic bleeding in 13 cases(3.47%).Anastomotic tumor recurrence was seen in 25 cases.Logistic regression analysis showed that the distance between the tumor and the dentate line was the most important factor for postoperative complications(P=0.017),and the distance and patient's age were the most important factors for recurrence(P=0.040,P=0.041). Conclusions The distance of tumor and patient's age are the most important factors for complications and recurrence following sphincter preserving procedure for rectal cancer.Strict selection of patients for surgery,normative procedure performance,and proper peri-operative management are essential for the prevention of complications and recurrence.

doctors from 72 township health centers in 3 counties of Jiangxi Province were given a written test in basic medical knowledge, clinical knowledge of prevention and healthcare and professional knowledge. The rate of excellence of the scores was 45.4% while the rate of failure was 16.9%. A comparative analysis is made of the differences in the scores of doctors of different sexes, ages, specialties, educational backgrounds, and professional titles. It is suggested that it is imperative to conduct training for all doctors so as to enhance the overall quality, to lay stress on the key points and focus on the tackling of the weak links, and to perfect the mechanism so as to promote the renewal of knowledge.

Objective To explore the correlation between P300 and Loewenstein occupational therapy cognitive assessment (LOTCA) results, and to analyze its clinical significance. Also to explore whether P300 might represent specific cognitive functions. Methods Sixty stroke patients were matched with 30 healthy persons serving as a control group. All were examined with auditory evoked potential P300 and the LOTCA, and the correlation between the results was analyzed.Results The stroke patients had significantly longer P200,N200 and P300 latencies and significantly lower P300 amplitude compared with the controls. The LOTCA total scores and each sub-item score in the patient group were all significantly lower than those in the control group. In the patient group, there was strong negative correlation between P300 latency and the total LOTCA score, weak positive correlation between P300 amplitude and the total LOTCA score, and medium to high negative correlation between P300 latency and LOTCA sub-item scores. Stepwise regression and multivariate analysis revealed that sub-items of LOTCA, followed by thinking operations, motor praxis and spatial perception, were strongly correlated with P300 latencies.Conclusions Significant correlation were found between P300 and LOTCA. The combination of P300 and LOTCA can enable earlier, more objective and more comprehensive assessment of vascular cognitive impairment. The latency of P300 has no obvious specificity in reflecting cognitive function, and it is affected by thinking operations most.

Objective To evaluate the damage to the brochial plexus produced by pulsed radiofrequency (PRF)and radiofrequency thermocoagulation(RFTC).Methods Fifty-five male Wistar rats weighing 250-300 g were randomly divided into 3 groups:groupⅠPRF(n=25):groupⅡRFTC(n=25)and groupⅢnormal control(n=5).The animals were anesthetized with intraperitoneal chloral hydrate.The left brochial plexus was exposed and PRF or RFTC was applied to the left brochial plexus.The voltage and current of the minimal stimulation which elecited muscle twitching and the impedance before and after operation were recorded in group PRF and RFTC.The nerve function was scored according to Tarloo(0=flaccid paresis,5=normal gait)before and at 3d after operation.The animals were killed and the left brachial plexus was removed immediately and at 1, 7,14,30 d after operation(n=5 at each time point)for determination of histopathological changes using microscope.Results The impedance and Tarlov score were significantly decreased after operation as compared to the baseline values before operation in group RFTC and were also significantly lower than in group PRF. Microscopic examination showed that the myelinated nerve fibers exhibited Wallerian degeneration and axon regeneration and the cytochondria in cylindraxile were severely injured or disappeared in group RFTC.The myelinated nerve fibers and the cytochondria in cylindraxile were significantly less injured after operation in group PRF than in group RFTC and returned to normal at 7 d and 30 d respectively.Conclusion The injury to brachial plexus produced by PRF is slighter than that produced by RFTC.

Objective To compare the assessment results of Loewenstein occupational therapy cognitive assessment (LOTCA) and mini-mental state examination(MMSE) in stroke patients,and to analyze the correlation between the two assessments and to explore the applicable values of LOTCA in assessing vascular cognitive function impairment (VCI).Methods According to the diagnostic standard of cognitive impairment with MMSE,thirty stroke patients with cognitive impairment were selected as cognitive impairment group,thirty stroke patients without markedly cognitive impairment as stroke control group,and thirty normal subjects served as normal control group.All the subjects' age,gender and level of education were matched in the three groups. All the subjects were assessed with LOTCA and MMSE.ResultsThe total scores of LOTCA had high positive correlation with the total scores of MMSE in cognitive impairment group ( r =0.934,P ＜ 0.01 ),the correlations were also found between every sub-items of LOTCA and those of MMSE (P ＜ 0.01 ).The total scores and the scores of sub-items of LOTCA in cognitive impairment group were significantly lower than those in stroke control group and were those in normal control group(P ＜ 0.01 ),particularly lower scores in LOTCA sub-items of thinking operations,orientation,visuomotor organization.The scores of sub-items of LOTCA,including thinking operations,visuo-motor organization,attention,orientation,spatial perception were all significantly lower in stroke control group than those in normal control group(P ＜0.01 ),especially in thinking operations and visuo-motor organization sub-items.Conclusions Correlations were found between LOTCA and MMSE.Compared to MMSE,LOTCA could detect vascular cognitive function impairment earlier and is much more comprehensive,so it is suitable to assess vascular cognitive impairment patients with no dementia.

Objective To investigate the risk of permanent hair dye use for connective tissue disease ( CTD ) with positive antinuclear antibodies ( ANA ).Methods We conducted a population-based case-control study to analyze 440 CTD patients from the department of our hospital.Four hundreds and forty patients' relatives or friends who were free from any CTD were selected as controls.Patients and controls were matched in sex and age.A face-to-face interview was adopted to finish questionnaires about subjects' demographic data and the use of permanent hair dye.Data about the duration,frequency,times of usage and allergy related to hair dye were collected.Medical history was also reviewed,such as the diagnosis,disease course,primary symptoms,serum tests and organ involvements.Statistical analysis was performed by SPSS 17.0 software using x2 test and Logistic regression.Results The association between the use of permanent hair dye and CTD did not reach statistical significance (OR=1.282,95％CI 0.966-1.700,P=0.085 ),when the relationship of hair dye use with systemic lupus erythematosus (SLE) was tested,the same result (OR=1.092,95％CI 0.795-1.500,P=0.587 ) could be revealed.Conclusion This preliminary study has shown that the use of permanent hair dye couldn't induce the occurrence of CTD.

Four-Dimensional Computed Tomography ; Humans ; Liver Neoplasms ; diagnostic imaging ; radiotherapy ; Lung Neoplasms ; diagnostic imaging ; radiotherapy ; Male ; Prostatic Neoplasms ; diagnostic imaging ; radiotherapy ; Radiotherapy Planning, Computer-Assisted ; methods ; Radiotherapy, Intensity-Modulated ; methods

Background It is imperative for the microbial monitor after opening the bottle of eyedrops in order to ensure the safety during use of ophthalmic solutions with multi-dose packaging.Objective This study was to research the microbiological properties and sterile duration of methylcellulose (MC) eye drops in three common environmental conditions,including room temperature condition of community,refrigeration condition of community and room temperature condition of hospital.Methods MC eye drops were assigned to the community room temperature group,community refrigeration group and hospital room temperature group,and 200 bottles of MC eye drops with or without ethylparaben were collected in each group,including sealed or unsealed drugs at average.The containers of all the eye drops were opened and the opening times were record.The drugs was admistered 1 drop for 3 times per day,with the opening period for 5-10 seconds.Then the drugs were preserved in different environments based on grouping.Microbial isolation and purification were performed by the same lab technician at 8:00 from 1 through 10 days after opening of drugs with automatic microbial analyzer.Results In the unsealed MC eye drops without ethylparaben,the bacterial positive rates were about 30％ in the community room temperature group,community refrigeration group and hospital room temperature group,but no microbial colony was seen in the sealed eye drops.Ten days after opening of containers,the bacterial cultured rates were 30％,32％ and 36％ in the eye drops without ethylparaben in the community room temperature group,community refrigeration group and hospital room temperature group,and those in the eye drops with ethylparaben were 15％,19％ and 23％,respectively,showing significant differences between the eye drops with and without ethylparaben (x2 =6.452,4.448,4.063,all at P＜0.05).The 95％ confidence interval (CI) of difference values of intergroup bacterial rates were-0.166-0.126,-0.110-0.190 and-0.088-0.208 between the community room temperature group and the community refrigeration group,between the hospital room temperature group and the community refrigeration group,between the hospital room temperature group and the community room temperature group respectively in the unsealed eye drops without ethylparaben,and those in the unsealed eye drops with ethylparaben were-0.159-0.079,-0.089-0.169 and-0.043-0.203 respectively,indicating insignificant differences among the groups.Cultured bacteria were identified as Micrococcus luteus,Acinetobacter lwoffii,Bacillus subtilis,Acinetobacter radioresistens,Myroides and Staptococcus xylosus.Conclusions Ethylparaben can reduce the contamination rate of microorganisms after opening of MC eye drops.Three environmental conditions do not play an influence on microbial contamination of MC eye drops after opening.The bacteria of contaminated eye drops appear to be common microorganisms in atmosphere and soil,rather than eye common pathogens.

Objective To evaluate the value of 64-slice spiral CT angiography based on pre- contrasted raw data in diagnosing pulmonary arteriovenous fistula.Methods 64-slice spiral CT plain scan and enhanced scan was performed in 16 patients with pulmonary arteriovenous fistula,pulmonary angiography based on pre-contrast and post-contrast raw data was performed respectively,including maximum intensity projection(MIP),shaded-surface display(SSD),and volume rendering(VR).According to the results of angiocardiography and surgical findings,comparson of the three methods was made in the display of PAVF in pre-contrast and post-contrast phase images.Results 8 of the 16 PAVF cases were single lesion,8 cases were multi-lesions.30 PAVF lesions were found in all the patients.MIP,SSD and VR based on pre-contrast raw data displayed PAVF lesions in 20,14,and 22,respectively.The combination of the 3 methods based on pre-contrast raw data could show 26 PAVF lesions.MIP,SSD,and VR based on post-contrast raw data displayed PAVF lesions in 24,18,and 30,respectively.The combination of the 3 methods based on post- contrast raw data could show 30 PAVF lesions.Conclusion 64-slice spiral CT angiography based on pre- contrasted raw data can clearly show the position,number,and shape of PAVF lesions,which is of great value in diagnosing PAVF.

Objective: To observe the effect of ZuoGuiWan and YouGuiWan on induced experimental autoimmune encephalomyelitis(EAE) in Lewis rats,compare the therapeutic effect between ZuoGuiWan and YouGuiWan,and explore the underlying immunoregulatory mechanism between warming-yang and nourishing-yin therapy.Methods : 120 male Lewis rats were bred at Capital Medical University under specifi c pathogen-free conditions.24 rats were selected as normal group before immunization.The other rats were randomly devided into 4 groups after immunization,including EAE group,prednisone group,ZuoGuiWan group and YouGuiWan group.Rats of normal group were injected with normal sodium in the hind feet pad on both sides,the other rats were injected with the antigen consisted of myelin basic protein(MBP) and complete Freund’s adjuvant(CFA) to induce EAE.Rats of normal group and EAE group were administered with normal sodium after immunization,rats of prednisone group with prednisone(5mg/kg),rats of ZuoGuiWan group with ZuoGuiWan(2g/kg),rats of YouGuiWan group with YouGuiWan(3g/kg).On the day 15 and 27 after immunization,the peripheral blood was collected,lymphocyte subgroups and NK cells were detected by ? ow cytometer.Results: On day 15 after immunization: In peripheral blood,the number of CD4+lymphocyte in ZuoGuiWan group was signifi cantly higher(P