Objective To evaluate the clinical efficacy of laparoscopy combined with colonoscopy for small colorectal space occupying lesions (equal or less than 3 cm). Methods From January 2010 to January 2015,a total of 41 cases of small colorectal space occupying lesions (equal or less than 3 cm)were treated under general anesthesia with laparoscopic surgery combined with colonoscopy.The patients were placed at the lithotomy position.After the establishment of pneumoperitoneum,injection of methylene blue for staining was carried out under colonoscopy. Laparoscopic titanium clipping positioning was conducted, and then the colonoscope was withdrawn.According to the intraoperative frozen pathological results,bowel resection surgery or colorectal surgical resection was selected. Results All the 41 cases of laparoscopic combined with colonoscopic surgery were successfully completed, with no conversion to laparotomy.There were 9 cases of preoperative diagnosis of precancerous lesions,6 of which were found neoplasia in the colon epithelium with intraoperative pathological diagnosis,with 3 cases of Tis adenocarcinoma.Among 32 cases of preoperative diagnosis of stage 0 -Ⅰ colorectal cancer,there were 29 cases of intraoperative and postoperative diagnosis of stage Ⅰ (23 cases of T1 N 0 M0 adenocarcinoma and 6 cases of T2 N 0 M0 adenocarcinoma)and 3 cases of stage Ⅲ (T2 N 1 M0 adenocarcinoma).Two cases were multiple lesions.Bowel resection was performed in colon intraepithelial neoplasia and Tis lesions of colorectal cancer,while resection of colorectal cancer was conducted in stage T1 -T2 colorectal cancer.Two patients with colonic epithelial neoplasia were followed up for 9 and 12 months,without recurrence.The remaining 39 cases were followed up for 24 -49 months,with a median of 38.6 months. Among the 35 cases of colorectal cancer,colonoscopy detected local recurrence in 1 case of T2 N 1 M0 adenocarcinoma (stage Ⅲ)after 34 postoperative months.No metastasis was found in all the patients. Conclusion Laparoscopy combined with colonoscopy for small diameter (equal or less than 3 cm)benign tumor or stage Tis -T2 malignant colorectal cancer has advantages of both endoscopy,especially suitable for difficultly located or removed lesions,which can improve the positioning precision and surgical safety.

This Tablet yields satisfactory result in lowering glucose and improving hemorheology. We have observed that, in addition to lowering of glucose level, it also elevates the content of RBC - SOD, inhibits the formation of MDA. and decreases the level of AchE. When comparison was made with that of Yuquan Tablet control group, the different was significant (P

Objective To investigate the ability of the four-slice perfusion maps derived by multislice CT(MSCT)perfusion imaging (CTPI) to detect ischemic lesion in rabbit models with the middle cerebral artery occlusion(MCAO). Methods Sequential dynamic CT studies were performed at four slices in 2 control rabbits and another 8 with MCAO. The volume of critically ischemic lesions on CTPI maps at 1st,2nd and 3rd hour after operation and the volume of infarction measured by postmortem 2,3,5- triphenyltetrazolium chloride (TTC) staining were analyzed by analysis of variance with random blocks design and linear correlation. Results In 6 of 8 animals of the ischemia group, critically ischemia or infarction was visible on perfusion maps and TTC-staining,while appearing negative in 2 control rabbits. In four-slice CTPI maps, lesions were visualized in 2 of 4 slices at least. The results of analysis of variance demonstrated that the intergroup differences were discovered between 1st , 2nd and 3rd hour after operation, and between MTT map and other CTPI maps (P

0.05).[Conclusion]Porcine articular cartilage extracellular matrix derived scaffold used in heterogenic transplantation or allograft have no immunologic rejection.This research provides a feasibility for application of xenogenic acellular cartilage to clinic.

Bone Neoplasms ; Female ; Humans ; Middle Aged ; Waldenstrom Macroglobulinemia

4-Chloromercuribenzenesulfonate ; pharmacology ; Adult ; Case-Control Studies ; Female ; Graves Disease ; metabolism ; physiopathology ; Humans ; Hydrogen Peroxide ; metabolism ; Iodine ; metabolism ; Male ; NADPH-Ferrihemoprotein Reductase ; metabolism ; Thyroid Function Tests

Objective To analyze the short-term impact of fast track surgery (FTS) combined with minimally inva-sive surgery on elderly patients with colorectal cancer. Methods 200 patients with colorectal cancer received laparo-scopic surgery from July 2013 to July 2015 were selected and randomly divided into control group and FTS group. Patients in control group received conventional perioperative treatment and patients in FTS group received perioper-ative management according to fast track surgery. Status of intraoperative, postoperative recovery and the postopera-tive complication rate were compared between the two groups. Patients' quality of life were analyzed after two weeks of operation. Results Compared with the control group, the blood loss, operation time and number of lymph node dissection of patients in FTS group showed no significant difference ( > 0.05). Flatus time, ambulation time, start eating time, the infusion time and length of hospital stay in FTS group was significantly shorter than the control group, the difference was statistically significant ( <0.05). The total cost of hospitalization of FTS group was signifi-cantly lower than the control group ( <0.05). The incidence of sore throat, abdominal distension, lung infections and overall complications incidence rate in FTS group were significantly lower than the control group, the difference was statistically significant ( <0.05). The satisfaction rate in FTS group was 96.0%(96/100), and was significantly high-er than the control group 82.0 %(82/100), the difference was statistically significant ( < 0.05). QLQ-C30 results showed that scores of overall health, emotional function and social function of FTS group were significantly higher than the control group ( <0.05), and scores of nausea and vomiting, pain, insomnia, anorexia, constipation were sig-nificantly lower than the control group ( < 0.05). Conclusion Laparoscopy combined with FTS is safe and effective in treatment of colorectal cancer in the elderly patients, which can promote postoperative rehabilitation, improve pa-tient satisfaction and quality of life in short term.

Objective To study the relationship between the cerebral artery stenosis and the carotid artery elasticity in the ischemia stroke patients by echo-tracking technique.Methods Ninety-two ischemia stroke patients were divided into both the mild cerebral arteries stenosis and moderate-severe cerebral arteries stenosis groups.CT angiography was performed to evaluate the stenosis of cerebral artery.The changes of the carotid diameter during cardiac cycles were obtained by echo-tracking technique and the quantitative parameters of pressure-strain elastic modulus (Ep),stiffness (β) and arterial compliance (AC) were calculated automatically. Results①There were significant differences (P＜0.05) between the ischemia stroke patient group and the normal adults group in β，Ep and AC.② There were significant differences (P＜0.05) between the mild cerebral arteries stenosis groups and the moderate-severe cerebral arteries stenosis groups in β and Ep.AC was lower in patients with the mild cerebral arteries stenosis groups than that in the moderate-severe cerebral arteries stenosis groups.Conclusions The carotid artery elasticity in ischemia stroke patients were significantly different from normal adults.In the ischemia stroke patients,the stiffer the carotid artery was,the higher the likelihood of moderate-severe cerebral stenosis was.

Objective To explore the clinical effect of extracorporeal shock wave lithotripsy (ESWL) for the treatment of horseshoe kidney stones.Methods A total of 42 cases of horseshoe kidney stones from March 1987 to January 2015 were enrolled.Among them,33 cases were male and 9 cases were female.Their age range was 19 to 71 years,average age was 42 years old.25 cases got left renal pelvis stone,17 cases were on the right renal pelvis side.The diameter range of stone was 0.4-3.7 cm,the average was 1.8cm.ESWL was applied to treat whole group.The prone position was used to removing calculus.The frequency of treatment was 2000-2700 times,with an average of 2500 times;the treatment voltage was 4-7KV.The gravel time of the treatment was 30-45min,the average was 35min.Results One time for ESWL was 29 cases,two times for ESWL was 8 cases,three times for ESWL was 3 cases,four times for ESWL was 2 cases.The first discharge stones time was 3 to 10 days.There was no special discomfort after operation.40 cases got hematuria after operation,which occurred in 1 to 3 days after ESWL Renal colic was in 7 cases which happened on 1-3 days after ESWL.Condusions Calculi in horseshoe kidney may be treated by ESWL.It is a safe and simple operation.The prone position may bring satisfactory effect.

Objective To evaluate clinical efficacy of extracorporeal shock wave lithotripsy (ESWL) for treating patients with double J (DJ) stent extubation difficulties.Methods A retrospective analysis were conducted from July 1999 to December 2013,total 30 cases (18 male and 12 female) were accepted the ESWL therapy for treating the DJ extubation difficult due to the stone scales surface.The average age in those patients was 46 years (range 24 to 83 years).The average duration of DJ stents indwelling was 8.3 months (range 1.5 to 36.0 months).There were 10 cases with single stone and 20 cases with multiple stones.The distribution of stone location included left kidney in 14 cases,right kidney in 6 cases,left ureter in 3 cases and right ureter in 7 cases.The ureteral stone scales around the DJ stent showed tubular distribution.The distribution of imaging characteristic included kidney stones around the DJ stent joint in 20 cases and surface coarse in 10 cases.The diameter of the stone ranged from 0.7 to 3.2 cm (mean 1.8 cm).All the 30 cases were treated by ESWL with the 2 000-3 300 times frequency (mean 2 800 times).Treatment voltage was 4-8 KV.Results Gravel time ranged from 40 to 70 min (mean 45 min).No intraoperative and postoperative complications occurred.Their DJ stents were easily extubated immediately after ESWL.One week after ESWL,all the patients reported the flushing of the stone.Conclusion ESWL is a simple,convenient and efficacy way to solve the DJ stent extubation difficulties due to the scales surface.