OBJECTIVETo study the patterns and prognostic value of resection margin involvement and lateral pelvic metastases, providing surgeons with pathologic proofs of tumor spread within the studied areas.

METHODSLarge tissue slices of 62 specimens from patients with rectal cancer were used in the pathologic study and the outcomes were followed.

RESULTSCompared with patients without margin involvement, patients with circumferential margin involvement (CMI), seen in 8 cases (12.9%), had poorer postoperative survival (P=0.003). The 12 patients (19.4%) with lateral pelvic metastases suffered poorer survival, compared with those without lateral pelvic metastases (P=0.026). Eight patients (66.7%) were diagnosed to have single lateral pelvic region involved, while the other 4 had multiple regions involved. The incidence of lateral metastases differed among regions, with higher occurrence in the root of middle rectal artery (6/12, 50.0%), area of the internal iliac artery (4/12, 33.3%) and the obturator region (3/12, 25.0%).

CONCLUSIONOccurrence of CMI or lateral metastases in rectal cancer patients predispose poor survival, thus a more radical clearance and postoperative adjuvant therapy are recommended.

Adult ; Aged ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Male ; Mesentery ; pathology ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Metastasis ; Neoplasm Staging ; Pelvis ; pathology ; Rectal Neoplasms ; mortality ; pathology

OBJECTIVETo study lateral pelvic metastasis and micrometastasis of low rectal cancer and elucidate their prognostic value.

METHODSWhole-mount slice and tissue microarray of dissected lateral pelvic specimen from 67 cases of low rectal cancer were examined, and the included cases were followed up.

RESULTSTwelve specimens were diagnosed as lateral metastasis, while another 10 were proved to bear micrometastasis. Most of the involved metastatic lymph nodes (82.9%) were smaller than 5 mm in diameter. Internal iliac, obturator regions and middle rectal root were more likely to be involved by tumors. Patients with lateral metastasis suffered more recurrence and poorer survival.

CONCLUSIONSLateral pelvic metastasis could be observed in low rectal cancer and its incidence differed among lateral pelvic regions. Patients with lateral spread predisposed poor prognosis, thus underlies the value of pre/postoperative adjuvant therapy.

Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Lymph Node Excision ; Lymphatic Metastasis ; Male ; Middle Aged ; Pelvis ; pathology ; Prognosis ; Rectal Neoplasms ; pathology ; surgery

Objective To compare the clinical efficacy between total aortic arch reconstruction with open triple-branched stent graft placement and total aortic replacement combined with stented elephant trunk implantation for patients with Stanford A aortic dissection.Methods Patients with Stanford A aortic dissection treated with surgical treatment from January 2006 to May 2011 were included in this study.The patients were divided into two groups.Group Ⅰ (n =20) patients were treated by total arch replacement with stented elephant trunk procedure.Group Ⅱ (n =8 ) patients received open triple-branched stent graft placement. Echocardiography and aortic CT angiography were performed before and at 1 month after operation.Results Age,gender and disease severity were similar between the 2 groups ( all P ＞ 0.05 ).Operation was successful in all 28 patients.Cardiopulmonary bypass time,aortic cross clamp time,circulation arrest time and duration of ventilator assisted breathing were significantly longer; postoperative drainage volume and blood transfusion volume were significantly larger and hospitalization cost was significantly higher in group Ⅰ patients compared those in group Ⅱ patients ( all P ＜ 0.05 ). One month after operation,the maximum internal diameter of aorta was smaller than pre-operation in both group Ⅰ [ (30.2 ± 3.1 ) mm vs.(42.5 ±6.5)mm,P ＜ 0.05] and group Ⅱ [(31.5 ±2.5) mm vs.(44.1 ±7.3)mm,P ＜ 0.05].Conclusions Short-term procedural success rate was similar between the two groups.The total aortic arch reconstruction with open triple-branched stent graft placement procedure is simpler,shortens the operation time,reduces the blood transfusion volume and is more cost-effective compared to the classical aortic arch operation.

Objective To establish an acute exposure model of extreme plateau hypobaric hypoxia environment and explore transcriptomic changes related to learning and memory impairment in rats.Methods Healthy male SD rats aged 6-weeks,200-250 g,were selected and divided into control group and plateau group.The control group was treated with normal pressure and oxygen(19 rats),and the plateau group was placed in a hypobaric hypoxia chamber(19 rats)at a simulated altitude of 8000 meters and treated for 72 hours.Behavioral changes were detected with 16 animals from each group using contextual fear conditioning and Morris water maze(8 rats each).Three hippocampal tissues were extracted from each group for transcriptomic sequencing,and the molecular mechanism of learning and memory impairment induced by extreme plateau environment was analyzed by Gene Ontology(GO),Kyoto Encyclopedia of Genes and Genomes(KEGG)and gene set enrichment analysis(GSEA)enrichment.Results The behavioral result showed that compared with the control group,the fear memory and spatial learning memory abilities of rats in plateau group were decreased.GO and KEGG analyses showed that the extreme altitude environment reshaped the hippocampal microenvironment and affected the intercellular signal transmission,while GSEA analysis showed that the extreme altitude environment up-regulated the gene set related to the plasma membrane and extracellular matrix.Conclusion The extreme plateau environment at an altitude of 8000 meters could affect the microenvironment of rat hippocampus,destroy intercellular connections and impair intercellular communication and then induce learning and memory impairment.

Objective To summarize the clinical effects and experiences of rapid pore cranial drilling and ventricular drainage treatment on ventricular hemorrhage to evaluate the performance of rapid pore cranial drilling. Methods The clinical data of 3571 patients with ventricular hemorrhage performed the rapid pore cranial drilling and ventricular drainage treatment from 13 hospitals of Shandong province since 1977 were retrospectively analyzed and concluded; these data were compared with those in patients received traditional Dandy's device. Results In these 3571 patients, the cure rate was 27.1%, the improvement rate was 49.1%, and the death rate was 23.8%. Rapid pore drilling needed no scalp incision, no suction, no coagulation, or no special lighting, only needed puncturing the scalp, drilling through the cranium and dura matter, implanting drainage tube and stitching it up; one can manage it in about 5 minutes at bedside; while the traditional Dandy's drilling occupied 3 people in the operating room, needed more than 20 procedures, and plus the time transporting the patient, it needed at least 60 minutes or more to finfish the procedures. Rapid pore cranial drill device is superior to Dandy's cranial drill device in operating procedures, technical performance, operation conditions, personnel and time-consuming. Conclusion Rapid pore cranial drilling greatly simplifies the operating procedures, saves precious time for the seriously ill patients, reduces the mortality and improves the effectiveness of the treatment. After 35 years of clinical practice, to those patients seriously ill needed ventricular drainage treatment to rescue their lives, rapid pore cranial drilling is superior to traditional Dandy's drill technic, and is an effective method treating such diseases.

[Abstract] Objective To investigate the role of dihydromyricetin (DHM) in the treatment of ischemic stroke in rats, and to explore the effect of DHM on the expression of inflammasome. Methods The middle cerebral artery occlusion (MCAO) model was induced by endovascular suture method. The therapeutic effect and mechanism of DHM were investigated by Longa score, TTC staining, Nissl staining, immunohistochemical staining and Western bloting. Results After DHM treatment, the motor capacity of MCAO rats was significantly improved, the infarct volume was significantly reduced, the brain structure and neuron morphology were improved, and the expressions of nod-like receptor protein-3 (NLRP3) and interleukin-1(IL-1) decreased significantly. Conclusion DHM can down-regulate the expression of NLRP3 and thus reduces the cerebral infarction volume and improves neurobehavioral performance in MCAO rats.

Objective The traditional round incision or cross incision brain harvesting method can not meet the requirements of protecting the donor's remains. In this study, the method of brain removal through a posterior incision on the scalp of both ears was proposed, which effectively protected the donor's remains. Methods Adopting the incision 2. 0 cm above the external occipital protuberance to the most front edge of the auricle to obtain a complete brain. Results The incision did not involve the head and face skin, which was small and conducive to suture repair and reduce exudation. Conclusion The incision effectively protects the donor' s remains, and it will be conducive to the establishment and development of the brain bank.

Objective To construct homozygous aquaporin 9(AQP-9)

[Abstract] Objective The purpose of this study is to construct a high-resolution model focusing on the vascular pattern of the scaphoid by using micro CT and to provide anatomical reference for the daily clinical use. Methods The lead-based contrast was perfused from the brachial artery and then the scaphoid bone was harvested. 3D models of the scaphoid bones were constructed by using micro CT to show how arteries distributed in and on the bones. Results The arteries on the surface stretched from the distal radius covered with scaphoid fossa to the radial side of the waist and then head back to the distal ulna along the dorsoradial ridge, formed like a letter “Ⅴ”. The arteries gathered at the inflection point of the letter “Ⅴ” and the dorsal region. The tubercle region was anastomosed extensively with 3 to 5 major intraosseous vessels originated from the extraosseous vessels covering the waist and the tubercle. There are only 1 to 2 major intraosseous vessels entering the bone via a long route from the ulnar side. The vessels running in the scapholunate ligament didn’t spilt into any intraosseous branches. Conclusion The superficial vascularity formes a “Ⅴ”-like pattern. The inflection point of the letter “Ⅴ” and the dorsal region display a dense vascularization and these vessels contributed a lot to the intraosseous vascularity.