Objective Observe the fine distribution and morphologic feature of the intramural lymphatics in rats' rectum and to provide the morphological evidence for studying the mechanism of lymphous metastasis of rectum carcinoma.Methods The intramural lymphatics of rectum in rats were studied by light and electron microscopy to obtain some data regarding their fine distribution.Results The intramural capillary lymphatics of rats' rectum were observed in deep lamina propria of tunica membrane and the dermal papilla layer of anal pectin. The intramural capillary lymphatics and lymphatics were both observed in tela submucosa, reticular layer, hypodermis and intermuscular and serosa. The capillary lymphatics in rectums' wall have the similar ultrastructure feature to normal ones. Three kinds of endothelial cells junctions are overlapping-junctions, embedding-junctions and end-to-end-type junctions. About 21% of cell-junctions are opening types. There are normal organelles and many vesicals in the endothelial of capillary lymphatics. Conclusion The distribution of lymphatics in every layer of dentate line upwards are similar to other digestive tubes'. The distribution of lymphatics in anal pecten of rats' rectum are similar to cutis. The results show that big molecule substance and tissue hydrolysate are transporting mainly by opening-junction of endothelial cells and the vesicle system.

Objective To investigate the expressions of Pokemon and c-myc in colorectal cancer,colorectal adenomas and normal colorectal mucosa tissues,and demonstrate its relationship with clinicopathological features and prognosis in patients with colorectal cancer.Methods The specimens were taken from colorectal cancer tissue of 86 patients,colorectal adenomas tissue of 60 patients,and 40 normal colorectal mucosa tissue.The expressions of Pokemon and c-myc protein were detected by immunohistochemistry,and the expressions of Pokemon and c-myc gene were detected by reverse transcription polymerase chain reaction (RT-PCR).The correlation between the expressions of Pokemon and c-myc,and clinicopathological features was analyzed.Results The positive expression rates of Pokemon and c-myc protein in colorectal cancer tissue were significantly higher than those in colorectal adenomas tissue and normal colorectal mucosa tissue:69.8％ (60/86) vs.13.3％ (8/60) and 5.0％ (2/40),73.3％ (63/86) vs.15.0％ (9/60) and 2.5％(1/40),and the expression levels of Pokemon and c-myc gene in colorectal cancer tissue were significantly higher than those in colorectal adenomas tissue and normal colorectal mucosa tissue:0.915 ±0.247 vs.0.358 ±0.102 and 0.277 ±0.085,1.272 ±0.360 vs.0.398 ± 0.153 and 0.255 ±0.097,there were statistical differences (P ＜ 0.05).The expression levels of Pokemon and c-myc gene in colorectal cancer tissue had a close correlation with the degree of infiltration,histological differentiation,lymph node metastasis,distant metastasis and Dukes stage,there were statistical differences (P ＜ 0.05),but had no correlation with the sex,age,and tumor diameter (P ＞ 0.05).Conclusions The expression levels of Pokemon and c-myc are higher in colorectal cancer tissue,and the expressions are related to the clinicopathological features of colorectal cancer.The expression levels of Pokemon and c-myc may predict the prognosis in patients with colorectal cancer.

Objective To investigate the clinical efficacy and safety of dexmedetomidine combined with sevoflurane in elderly patient undergoing percutaneous nephrolithotomy.Methods Forty ASA Ⅰ ～ Ⅱ elderly patients of both sexes,aged 65 ～ 76 (71.0 ± 6.0)yr,scheduled for elective surgery of percutaneous nephrolithotomy under general anesthesia,were randomly divided into two groups (n =20 each):dexmedetomidine/sevoflurane group (group D) and propofol/sevoflurane group (group P).All patients received fentanyl,propofol,and cisatracurium for anesthesia induction.After endotracheal intubation,patients in group D received an initial loading dose of 0.5 μg/kg (4 μg/ml) of dexmedetomidine over 10 min,followed by a continuous infusion of 0.3 ～ 0.6 μg/(kg · h).Patients in group P received an initial loading dose of 1 mg/kg of propofol over 10 min,followed by a continuous infusion of 3 ～ 6 mg/(kg · h).All patients received the inhalation of sevoflurane for maintenance.Bispectral index was used to maintain a similar level of hypnosis in both groups (40 ～ 60).The heart rate (HR),blood pressure (BP) [systolic blood pressure (SBP)/diastolic blood pressure (DBP)],oxygen saturation (SpO2),end-tidal carbon dioxide partial pressure (PETCO2) at different time points before anesthesia (T0),10 min after prone position (T1),30 and 60 min started lithotripsy (T2-3),and at the end of operation (T4) were recorded,respectively.The operation time,amount of blood loss,and volume of fluid infusion were recorded.Recovery time of spontaneous ventilation,awaking time (open eyes by calling),extubation time,staying time at postanesthesia care unit (PACU),and relevant complications were also recorded.Results Compared to the baseline value at T0,SBP and DBP were significantly decreased at T1 in both groups(P ＜0.05),and no significant differences in the SBP,DBP,SpO2,and PETCO2 were found between two groups(P ＞ 0.05).Compared to the baseline value at T0,the HR was significantly decreased at T1 ～ T4 in group D (P ＜ 0.05),the HR was significantly lower at T1 ～ T4 in group D than that of group P (P ＜ 0.05).No significant differences in operation time,amount of blood loss,and volume of fluid infusion were found between two groups (P ＞ 0.05).No significant differences in recovery time of spontaneous ventilation,staying time at PACU,nausea,vomit,and agitation were found between two groups (P ＞ 0.05),while awaking time and extubation time were significantly longer in group D than that of group P(P ＜ 0.05).The shivering was significantly less in group D than that of group P (P ＜ 0.05).Conclusions Both dexmedetomidine/sevoflurane and propofol/sevoflurane anesthesia are suitable for elderly patients undergoing percutaneous nephrolithotomy.Dexmedetomidine/sevoflurane makes time of awake and extubation longer,but dexmedetomidine can reduce the shivering and the attendant complications caused by shivering.