Objective To investigate the clinical value of anus-preserving operation for ultra low rectal cancer.Methods The clinical data of 226 patients with ultra low rectal cancer who were admitted to the Yijishan Hospital between January 2009 and September 2013 were retrospectively analyzed.All the patients were divided into the anus-preserving group (117 patients underwent traditional or modified Dixon operation) and the control group (109 patients underwent Miles operation).The operation time,volume of intraoperative blood loss,number of lymph node dissection,recovery time of intestinal function,postoperative short-term amplications,local recurrence and distal metastasis of tumors,survival rate and quality of life in the 2 groups were analyzed.The measurement data with normal distribution were presented as (x) ± s and analyzed using t test,count data were analyzed using Pearson chi-square test.The survival curve was drawn by Kaplan-Meier method,and the survival rate was analyzed using the Log-rank test.The patients were followed up by regular out-patient examination and telephone interview up to September 2014.Results The traditional Dixon operation was performed on 108 patients,modified Dixon operation on 9 patients and Miles operation on 109 patients in the control group.The operation time and volume of blood loss were (117 ± 12) minutes and (110 ± 51) mL in the anus-preserving group,which were significantly different from (122 ± 8) minutes and (155 ± 44) mL in the control group (t =3.80,7.09,P ＜ 0.05).The number of lymph node dissected and time of intestinal function recovery were 13 ±4 and (2.8 ± 0.8)days in the anus-preserving group and 13 ±4 and (2.7 ± 0.7)days in the control group,respectively,with no significant difference (t =0.90,0.83,P ＞ 0.05).Among the 184 patients receiving postoperative chemotherapy,19 patients terminated the chemotherapy due to serious response to chemotherapy,17 patients received radiotherapy after chemotherapy,9 patients received interventional treatment for liver after chemotherapy and 42 patients didn't receive the chemotherapy.The incidence of perianal eczema were 15.38％ (18/117) in the anus-preserving group and 3.67％ (4/109) in the control group,with a significant difference between the 2 groups (x2=8.81,P ＜0.05).The cases of anastomotic leakage,intra-abdominal bleeding,intra-abdominal infection,postoperative urinary retention,infection of incision and incision dehiscence were 4,3,5,10,7 and 9 in the anus-preserving group,which were not significantly different from 0,2,4,11,8 and 5 in the control group (x2=1.86,0.14,0.05,0.16,0.19,0.94,P ＞ 0.05).One-hundred and ninety patients were followed up for a median time of 34.5 months (range,12.0-57.0 months).The rate of local tumor recurrence,rate of distant metastasis and 1-and 3-year survival rate were 8.55％ (10/117),5.98％ (7/117),94.8％ and 76.2％ in the anus-preserving group and 8.26％ (9/109),5.50％ (6/109),95.7％ and 76.1％ in the control group,with no significant difference between the 2 groups (x2 =0.01,0.02,0.08,0.00,P ＞ 0.05).The score of life quality was 66 ± 14 in the anus-preserving group,which was significantly higher than 49 ± 11 in the control group (t =10.13,P ＜ 0.05).Conclusion The anus-preserving operation for ultra low rectal cancer is safe and feasible based on strictly grasping operative indications,meanwhile,it can improve the postoperative life quality of patients.

Objective:To investigate the effect and the mechanism of Apigenin on lipopolysaccharides ( LPS )-induced inflammatory mediators production in murine macrophages. Methods:The murine macrophage cell line RAW 264. 7 cells were cultured in vitro,and were treated with different concentration of Apigenin followed by LPS administration. Expression of heme oxygenase-1 ( HO-1),cyclooxygenase-2 (COX-2) and inducible nitric oxide synthase (iNOS),phosphorylation of p38 and IκB,nuclear translocation of Nrf2 were detected by Western blot. Production of Nitrite and nitrate ( NOx) was analyzed by colorimetric technique. Secretion of prosta-glandin E2 (PGE2) was detected by ELISA. Activation of NF-κB was measured by luciferase assay. Results: Western blot indicated that apigenin could induce RAW 264. 7 cells expression of HO-1, and pretreatment of SB203580, an inhibitor of p38 significantly inhibited apigenin induced HO-1 expression. In addition,Apigenin could also decrease the content of nuclear transcription factor Nrf2 in cytoplasm and increase its level in the nucleus. Silencing of Nrf2 by specific siRNA could inhibit apigenin-induced HO-1 expression. Furthermore,apigenin administration significantly inhibited LPS-induced NOx production and PGE2 secretion, COX-2 and iNOS expression,IκB phosphorylation and NF-κB activation,and transfection of HO-1 siRNA could reverse these actions. Conclusion:Apigenin inhibits LPS-induced inflammatory response through induction of HO-1 and inhibition of NF-κB in macrophages.

Objective To explore the perioperative experiences of congenital heart disease in infants.Methods From Jan.2000 to Aug.2006,109 patients with congenital heart disease were operated in our department,their clinical data were retrospectively collected and analyzed.The patients′ age ranged from 31 days to 3 years old (13.6 months).The body weight ranged from 2.1 to 16 kg (8.6 kg).Ninety-three patients were operated under hypothermic anaesthesia with cardiopulmonary bypass(CPB).Sixteen patients underwent deep thermal and low flow CPB.Ultrafiltration was used in 62 patients.Results There were 8 deaths and the operative mortality was 7.3%,4 cases caused by low output syndromeclos(LOS),3 cases caused by pulmonary hypertension and 1 case caused by lung intection.The morbidity was in 25 cases(22.9%),the main complications were LOS in 6 patients and respiratory complications in 18 patients,hydropericardium in 1 case,respectively.Conclusion To improve the operative and CPB technique,and to improve the skills of the postoperative managements of LOS and respiratory complications are the main points in the success of the cardiac operation in infants.

ObjectiveTo find out the electroencephalogram(EEG)change of the children with language retardation.MethodsThe EEG change and prognosis of 78 cases of language retardation children were analysed and compared with normal ones.ResultsThe EEG abnormal rate of language retardation was 69.3%,while that of the normal children was 10%(P<0.001).Conclusions The EEG is helpful to understand the developmental status of brain functions.

Objective To study the susceptible factors of atherosclerotic stenosis before the coronary artery myocardial bridges.Methods The data from 88 myocardial bridge cases which received coronary angiography were statistically analyzed.Sixty-seven cages which suffered from atherosclerofic stenesis in proximal of the myocardial bridges were recruited into group A,and the other 21 cases which suffered no atherosclerotic stenosis or from atherosclerotic stenosis in distal of the myocardial bridges were mcmited into group B.Difference of the age,gender,length of myocardial bridge,systolic blood pressure (SBP),diastolic blood pressure (DBP),pulse pressure (PP),the oppression degree of myocardial bridge (Nobel classification),fasting plasma glucose (FPG),and blood fat,and so on,in two groups,were observed and statistically analyzed.Results The difference of the Nobel classification,SBP and PP in two groups showed a statistical significance (P＜0.05).While the difference of the age,gender,length of myocardial bridge,DBP,FPG,total cholesterol,low-density hpoprotein in two groups showed no statistical significance (P＞0.05).A further regression analysis suggested that Nobel classification and PP had a correlation with the comphcation of stonosis before the myocardial bridge (r=3.0569,0.9740,P＜0.05).Conclusions High blood pressure cases are liable to suffer from myocardial bridge.Myocardial bridges themselves trend to promote or accelerate the atherosclerotic stenosis of the coronary arteries before.them.The oppression degree of myocardial bridge and PP has a correlation with the complication of stenosis before the myocardial bridge,while has no correlations with age,gender,bloodfat,SBP,DBP,FPG,length of myocardial bridge,and so on.

OBJECTIVETo investigate the applications of percutaneous screw fixation for the treatment of pelvic fractures and its related surgical considerations.

METHODSFrom June 2010 to June 2012,19 patients with pelvic fractures were treated with percutaneous hollow screws. There were 13 males and 6 females, with an average age of 41 years (ranged from 22 to 58 years). Fractures were caused by traffic accidents in 11 cases, by falling down from high place in 8 cases. Based on the Tile classification, there were 15 cases of Tile C type and 4 case of Tile B type. The indexes such as screw inserting time, intraoperative blood loss, complications, functional recovery and reduction conditions were observed. Fixation methods included sacroiliac screws, cannulated screw fixation of the pubic ramus and cannulated screw fixation of the pubic symphysis separation.

RESULTSAnatomical reduction achieved in 7 cases, satisfactory reduction 11 cases, and unsatisfactory reduction 1 case. Union time of fracture union ranged from 8 to 12 weeks (mean 10 weeks). Wound infection,ununion of fracture and nerve injuries were not found. According to the Majeed standards, 12 patients obtained an excellent results, 6 good and 1 fair.

CONCLUSIONPercutaneous screw fixation for the treatment of pelvic fractures under fluoroscopy has several advantages such as less trauma, less blood loss, fewer rates of complications, reliable fixation and no blood transfusion, which can reconstruct the stability of the pelvic ring, but it needs adequate preoperative preparation and high requirements for the surgeon.

Adult ; Bone Screws ; Female ; Fracture Fixation, Internal ; Fractures, Bone ; diagnostic imaging ; surgery ; Humans ; Male ; Middle Aged ; Pelvic Bones ; diagnostic imaging ; injuries ; surgery ; Radiography ; Young Adult

Objective To investigate the imaging features of the nigrosomes-1 region in the substantia nigra at 3.0 T with enhanced gradient echo T2 star weighted angiography(ESWAN), and to explore its clinical value in the evaluation of Parkinson disease (PD). Methods Fifty-four patients diagnosed with PD (PD group), and 51 non-PD volunteers (N-PD group) were scanned with 3.0 T ESWAN, who had selected randomly. The widths of the typical high signal correspondence with the nigrosomes-1 region (a), the width at the middle of the substantia nigra (b) and the width of the banded high signal of which the oval structure were not displayed (c) were measured and collected. The result of reclassification performed by 2 physicians were compared with clinical gold standard. Specificity and sensitivity were calculated; Eleven outpatients with clinically suspected PD but undiagnosed (UD group) were continusouly selected. They received the same scanning and were performed with imaging diagnosis according to the conclusions of previous studies, then compared the imaging diagnosis with the final clinical diagnosis. Results In non PD group, hyperintensity of nigrosomes-1 were shown in 49 cases (96.1%) in bilateral or unilateral of the SN, the hyperintensity were shaped as“drop”, wedge or oval and the average size (a/b) was (0.31 ± 0.07)mm approximately; PD group, all 54 cases (100.0%) of the oval rear the“drop”were completely disappeared. The sensitivity of the loss of the hyperintensity of nigrosomes-1 for the diagnosis of PD was about 100.0%(54/54)and the specificity of it was about 96.08%(49/51). In UD group, 7 cases with the“drop”completely missed and 1 case with smaller“c”were clinically proven to PD, 2 cases with the typical hyperintensity and 2 case with larger“c”were proven to Parkinson plus syndrome. Conclusions The nigrosomes-1 typical hyperintensity in PD patients' substantia nigra on the 3.0 T ESWAN are disappeared. There may be an effective method for PD and Parkinson's plus syndrome identification that by analyzing of the presence or absence of the typical hyperintensity and its size in the patients with symptoms of PD.

Objective:To clone and express the Staphylococcus aureus Efb(extracellular fibrinogen-binding protein) protein in Escherichia coli, to purify the expression product and prepare its functional antibody and to detect the functions of Efb protein for further studies on S.aureus infection.Methods: Efb gene was amplified by PCR using S.aureus NCTC-8325 genome DNA as template and cloned into the recombinant expression vectors pET28a. E.coli BL21(DE3) with the plasmid was induced with IPTG for protein production. The protein was purified by Ni~(2+) affinity chromatography. The function of Efb protein was determined by complement activity assay and inhibition ELISA.The polyclonal antibodies were prepared by immunizing the animals. Results: The purified recombinant Efb was obtained, which could inhibit the CH50 and AH50 effectively. The functional poly-antibodies of Efb were prepared.Conclusion:Efb could inhibit the classical pathway and alternative pathway of complement activation, and the antibodies against to Efb could block the inhibition of the classical pathway of complement activation induced by Efb.

Objective To observe the time-dependent changes of astrocytes and microvessels in the ischemic core and surrounding areas.Methods Glial fibrillary acidic protein (GFAP)was measured by HE,and CD31 by immunohistochemistry as markers in post-mortem specimens from ten patients,who died of cerebral infarction.Results Each section of the infarcted brains was divided into four areas (the area 0-3).GFAP expressed a little in area 0 and 1,increased in a time-dependent manner in area 2 and 3;CD31 die not expressed in area 0,expressed a little in the area 1,and increased in area 2 and 3 continuously.Conclusions The proliferation of astrocytes and microvessels may play a significant role in the process of restoration after cerebral infarction.

Objective To explore a good of treating posttraumatic deviated nose. Methods Clinical data of 136 patients with posttraumatic deviated nose were analyzed.Closed nasal bone replacement was employed in 34 patients with the disease history of 20-30 days,while open rhino- plasty approach was employed in 102 patients with the disease history over 6 months to correct their postt- raumatic deviated nose,and straightening the septum and ectomizing the inferior turbinate were done if necessary.Results The follow-up was over one year.In the 34 patients with the disease history of 20- 30 days,the outcome was excellent in 28 cases and good in 6.In the 102 patients with the disease history over 6 months,the outcome was excellent in 81 cases and good in 21.The deformity of nose was corrected satisfactorily.Normal nasal shape and good ventilation were obtained.Conclusion Posttraumatic devi- ated nose deformities are often caused by delayed and inaccurate treatment.Closed nasal bone replace- ment can be employed for the patients with trauma history less than one month,and open rhinoplasty ap- proach and straightening the septum and restoration of the nasal shape are employed for other patients.In this way good results can be obtained.