Objective To explore the advantages and disadvantages of laparoscopic combined with colonoscopic surgery (double endoscope surgery) and open surgery in the treatment of special types of colorectal polyps. Methods The clinical data of 62 patients with special types of colorectal polyps (wide base sessile, special parts or suspected cancerous, endoscopic resection difficult or high risk) were retrospectively analyzed. Among them, 42 patients underwent double endoscope surgery (double endoscope group), and 20 patients underwent open surgery (open group). The operating time, amount of bleeding during operation, postoperative exhaust time, postoperative hospital stay and complication rate were compared between 2 groups. Results All the patients had successful resection of the polyps, and there were no operative deaths. There was no conversion to open surgery in double endoscope group. Two patients in the open group were unable to locate the lesion by the tactile sensation of the hand and then succeeded in locating by intraoperative colonoscopy. The operating time, amount of bleeding during operation, postoperative exhaust time, postoperative hospital stay and complication rate in double endoscope group were significantly lower than those in open group: (60.5 ± 25.4) min vs. (75.8 ± 20.6) min, (30.5 ± 15.8) ml vs. (55.2 ± 24.6) ml, (24.6 ± 10.5) h vs. (40.5 ± 16.8) h, (3.2 ± 1.0) d vs. (5.8 ± 2.2) d and 0 vs. 20% (4/20), and there were statistical differences (P<0.05). There was 1 case with early postoperative inflammatory bowel obstruction, 1 case with abdominal infection and 2 cases with incision infection in open group. There was no operative death in the two groups, and these patients were cured by conservative treatment. The follow-up time was 3-36 (18.6 ± 12.3) months, and all the patients survived. The patients in 2 groups had no recurrence and metastasis, no anastomotic stenosis, anastomotic leakage and other complications. Conclusions For the special types of colorectal polyps, double endoscope surgery is less invasive, with faster recovery and less complications. It is the first choice except for endoscopic resection.

Objective To determine the surgical procedures and effects of ultra-distal tibial intramedullary nails combined with blocking screws in treatment of distal tibial fractures.Methods From April 2008 to September 2012,21 cases of distal tibial fractures were treated with ultra-distal tibial intramedullary nails combined blocking screws.All fractures were statically locked and closed using undreamed technique.For relatively simple fracture,blocking screws were considered when the reduction and stability was not satisfied after the insertion of intramedullary nails; for severe comminuted fractures,blocking screws were inserted directly under C-arm fluoroscopy.Partial weight-bearing was permitted 3 weeks after surgery.Quality of reduction,fracture union,and function assessment were measured at follow-up.Results No skin necrosis and soft tissue and bone infections occurred after a mean follow-up of 17.5 months (range,12-22 months).All fractures were healed with an average healing time of 12 months (range,8-26 months).X-ray findings revealed the fracture of ＜ 5° angulation on coronal and sagittal planes.There was no deformation or breakage of blocking screws and intramedullary nails.According to the criteria of Tormetta,the results were excellent in 19 cases and good in 2.Conclusion Blocking screws assists reduction and improve the fixation stability by narrowing the canal in treatment of distal tibial fractures and expands the application of intramedullary nails.

Objective To explore the effect of high-fat diet(HFD) on redox states of duodenum and calcium absorption in mice,and to analyze the relation between them.Method Fifty C57BL/6 male mice were randomly assigned to five groups.The control group consumed an ordinary diet(0.6% Ca,w/w),and other four groups were fed with HFD(19.64%lard,0.6% Ca),HFD plus 0.1% lipoid acid(LA),HFD with calcium supplement(1.6%Ca) and HFD with 1.6% Ca and 0.1% LA supplement.Calcium apparent absorption was measured by mineral balance study after feeding for 8 w.Plasma and duodenum levels of ROS,SOD,CAT,MDA,GSH/GSSG,and T-AOC were measured to evaluate the antioxidant status.Results HFD induced oxidative stress of duodenum and decrease of intestinal calcium absorption in mice.There were positive correlations between calcium apparent absorption with GSH/GSSG(r=0.801,P

Objective To investigate the changes in femoral gene expression profiles in C57BL/6 mice fed high-fat diet (HFD) via clustering analysis of DNA microarray.Method Sixteen male C57BL/6 mice (4w old) were randomly assigned to two groups,8 in each,after 4-d ordinary diet for adaptation.The control group was fed with an ordinary diet,and the HFD group with HFD(19.5% lard).All mice were sacrificed at the end of 12w and the femoral gene expression was detected by oligonucleotide microarray analysis with Affymetrix Gene Chip Mouse U430A.DAVID,an online tool,was used for clustering analysis on femoral gene expression.Results Longtime administration of HFD caused femoral gene expressed differences related to cation ion channel,transcription regulation and signal transduction,bone mineralization,phosphate metabolic process regulation,and collagen synthesis.Conclusion Longtime intake of HFD will change the expression of numerous bone metabolism-related genes in bone of mice,and then inhibit bone formation.

Objective To investigate the adhesion mechanism of Lactobacillus acidophilus FN001外to Peyer's patches. Methods Adhesion of L. acidophilus FN001 to mice Peyer's patches was studied in vitro using a fluorescent quantization method. The nature of adhesion mediator was studied by the effects of physical, chemical and enzymatic pre-treatments of the bacteria on their adhesion and effect of sugars on in- hibition of adhesion. The presence of lectin-like proteins in the cell surface was determined by hemagglutina- tion. Effect of L. acidophilus FN001 on inhibition of adhesion of pathogens to Peyer's patches was also stud- ied. Results The adhesion of L. acidophilus FN001 was strongly inhibited in the presence of D-mannose and methyl-ct-D-mannoside. Pretreatment of L. acidophilus FN001 with pepsin and trypsin decreased the ad- hesive capacity indicating that cell surface proteins are involved in adhesion to Peyer's patches. L. acidophi- lus FN001 could agglutinate rabbit red cell in mannose specific manner and protease pretreatment could de-crease hemagglutinin, suggesting that L. acidophilus FN001 has mannose specific lectin (s). In adherence inhibition assay, L. acidophilus NF001 could significantly inhibit adhesion of E. coli ATCC25922 to Peyer's patches when L. acidophilus NF001 were applied to Peyer's patches first or at the same time with pathogen. Conclusion It was concluded that a mannose-specific protein mediated adhesion of L. acidophilus FN001 to the Peyer's patches, and L. acidophilus FN001 could inhibit adhesion of pathogen with similar lectins speci- ficity to Peyer's patches.

Objective To establish pulmonary acute lung injury(ALI)model in rats.Methods ALI model was induced in rats by intratracheal Escherichia coli injection[3 ml/kg,O111B4,(4.0～6.0)×1012 CFU/L].Mechanical ventilation was applied 12,24,36,48 and 72 h after Escherichia coli injection,PaO_2/FiO_2 and dynamic compliance were recorded,and the normal control group was also subjected to mechanical ventilation.After the experiment,lungs were fixed with formalin to perform pathological examination.Results At 12,24,36,48 and 72 h,the PaO_2/FiO_2 were(30.71±7.95)kPa,(21.66±5.34)kPa,(21.09±4.75)kPa,(25.01±8.78)kPa and(33.82±8.02)kPa,respectively,which were significantly lower than that in the normal control group(63.82±3.03)kPa(P＜0.01).At 12,24,36,48 and 72 h,the Cdyn were(4.23±0.13)ml/(kg·kPa),(4.19±0.96)ml/(kg·kPa),(4.28±0.69)ml/(kg·kPa),(4.44±0.62)ml/(kg·kPa)and(4.58±0.35)ml/(kg·kPa)respectively,which were significantly lower than that in the normal control group(8.16±0.78)mL/(kg·kPa)(P＜0.01).At 12,24,36,48 and 72,the percentage of ALI was 71.4%,100.0%,100.0%,83.3%and 57.1%respectively,and the percentage of ARDS was 28.6%,85.7%,83.3%,66.7%,14.3%respectively.As for pathological examinations,predominance of alveolar collapse,fibrinous exudates,alveolar wall edema and neutrophil recruitment into the alveolar space was observed.Hyaline membrane formation was found.At 72 h,inflammation was relieved.Conclusion We successfully established pulmonary ALI/ARDS model in rats induced by intratracheal Escherichia coli injection,and acquired some useful information by observing the lung function and morphological changes at different time points.

The MAPKs activation pathway consists of three protein kinases in activation sequence:MAPKs kinase kinases (MKKKs)→,MAPKs kinases (MKKs)→MAPKs and four pathways:extracellular signal-regulated kinase (MAPK~(ERK)),C-JUN N-terminal kinase (MAPK~(JNK)),MAPK~(P38) and MKKS/MAPK~(ERK5) activation pathways.It has been proved that MAPKs(ERK,JNK and P38) are acvtivated in the progress of morphine tolerance.Inhibitors of any element of MAPKs activation pathway may function as a potential clinical medicine for morphine tolerance.

Objective To improve the arthroscopic posterior cruciate ligament (PCL) reconstruction using tibial Inlay technique. Methods The special arthroscopic device and related fixation technique were designed. Five cadaveric knees were used to simulate the process of arthroscopic posterior cruciate ligament reconstruction using tibial Inlay technique. The knees were cut open to observe whether the outlet of the tibial tunnel shape and location met the design requirements. Thirty normal MRI films were measured to identify tunnel angle and localizer angle. Results The inner outlet of tunnel was conical shape(14 mm×7 mm×15 mm) and the outer outlet was cylinder-shaped (a diameter of 7 mm). The tibial drill was designed into a split structure and could be assembled in vitro. According to the data obtained from MRI films, the angle between the plane of posterior cruciate ligament and horizontal place was 36°-47°, and the localizer was fixed at 50°.The achilles tendon was used as implant and the allogft bones were designed into conical shape to fit the inner outlet of tunnel. The other end of implant to the proximal tibia was fixed with button plate. All reconstruction operations were performed under arthroscopy. The outcomes of procedure were satisfactory. There were no vascular or peripheral nerve injuries in the cadaveric knees The tunnel position was accurate and the shape of tunnel had met the design requirements. Conclusion Our results imply that improved arthroscopic of posterior cruciate ligament using tibial Inlay technique is simple, accurate, rapid and stable fixation.

Objective To explore the anti-inflammatory effect of antiflammin-2 (AF2) and recombinant peptide sequence 2(R2) on acute lung injury of mouse. To observe the expression of clara cell 16000 protein (CC16) and surfactant protein A (SP-A) in the lung of mouse inoculated with lipopolysaccharide (LPS) and the impact of AF2,R2,and glucocorticoids(hydrocortisone,HC) may have on the expression of the CC16 and SP-A in the lung of mice with acute lung injury. Methods Balb/c mice were inoculated with LPS (5 mg/kg) by intraperitoneal injection to set up ALI mice model. Mice weighed from 15 g to 16 g were grouped into control group, model group and treated groups respectively treated with AF2, R2 or HC. Mice in the control group were injected with physiological saline solution, while mice in the other four groups were inoculated with LPS to induce acute lung injury. Then animals in the treated groups were treated with AF2, R2 or HC each on a dose of 2 mg/kg also through intraperitoneal injection,while those of the control group and the model group, were given equivalent physiological saline solution as a placebo. The respiratory rate of all of these animals were recorded 6 hours after the injection. And at the time point of 12 hour,all the mice were sacrificed for a preparation of the whole lung tissue for the sake of a pathological investigation ,or for extractions of RNA for a semiquantitative analysis of the expression of CC16 and SP-A within the lungs. Results (1) An obvious attenuation of the respiratory rates of the three treated groups were observed when comparing with that of the mice in the model group without any anti-inflammatory treatment. (2) Remarkable extenuation of the extent of intra-alveolar and intersticial hemorrhage and infiltration of inflammatory cells were observed within the treated groups comparing with that of the model group. (3) An attenuate expressions of CC16 or SP-A were observed in the model group,while obvious uptrend of CC16 expression was observed in AF2 treated groups and increase of SP-A expressions were found in R2 and HC treated groups. Conclusion The anti-inflammatory effect of the peptide, AF-2 or R2, has been conformed on ALI mice model induced by LPS.

Objective To evaluate the diagnostic value of transrectal three-dimensinal ultrasonography for virgin polycystic ovarian syndrome(PCOS) patients.Methods Transrectal three-dimensional ultrasonography were performed on 45 virgin patients with PCOS,30 with polycystic ovary(PCO) and 25 controls.Ovarian follicle numbers(FN),ovarian volume(OV),ovarian stroma area(SA),total area(TA) and SA/TA ratio and correspondent biochemical parameters were measured.Results Transrectal ultrasonography was more reliable than abdominal ultrasonography in the detection of delicate structure of ovary in virgin patients.This method was noninvasive,convenient,distinct and sensitive.Patients with PCOS showed sinificantly higher SA and SA/TA compared to those of the PCO group and control group.Conclusions In the case of detection of PCOS in virgin patients,transrectal three-dimensional ultrasonography combined with transabdominal ultrasonography can improve the precision of the diagnosis of PCOS.The SA/TA ratio might be considered as the ultrasound diagnostic parameter in PCOS.