Objective To investigate the anatomical mark of attachment edge in mesorectal tail and the effect of its morphologic distribution in performing total mesorectal excision (TME). Methods The gross specimens of 220 consecutive patients with the middle lower rectal cancer were collected by a group of surgeons.Patients were divided into two groups.①Group in saving sphincter. Ⅰa group, low anterior resection (LAR): 81 patients with lesions between 5 and 6 cm from the anal verge underwent LAR ; Ⅰb group, anterior resection (AR): 68 patients with lesions between 7 and 8 cm from the anal verge underwent AR.②Group in resecting sphincter. Abdominoperineal resection (APR): 71 patients with lesions between anal verge and 5 cm from the anal verge underwent APR. Results ①The circular edge of mesorectal tail is attached on rectal wall of 1 cm above anal hiatus of levators,which level parallels the lower margin of lower rectal cancer.In order to reset distal rectal wall of 2 and 3 cm,undergoing LAR must avoid injuring rectal wall when dissecting muscular vessel of rectum continue along the levators fascia to the anal hiatus.②The attachment morphology of mesorectal tail is a circular flake and not circular linear in shape. There are a little of fat tissue between posterior rectal wall and mesorectal tail,the length of its longitudinal attachment is (1.269?0.171) cm (81 cases in LAR group and 71 cases in APR gourp).Because the distal resective margin of rectum undergoing AR just locate in area of flake attachment of mesorectum, removing mesorectum around rectal wall must avoid injuring the rectal wall. Conclusion The mesorectal tail is a circular flake and attaches on rectal wall of 1.0 cm above anal hiatus of levatorani.Undergoing LAR or AR must avoid to injure rectal wall,which may result in leakage of anastomosis when removing mesorectal tissuce around distal rectal wall.

Objective To investigate the efficacy of laparoscopic radical resection for colorectal cancer. Methods From September 2000 to December 2004, 99 patients with colorectal cancer underwent laparoscopic radical resection (laparoscopic group) and 198 patients with colorectal cancer underwent open radical resection (open group) at the Union Hospital of Fujian Medical University. The differences in local recurrence and survival between the two groups were compared. The local recurrence of tumors and survival of patients in the two groups were calculated by the life-table method, and were compared by the Wilcoxon (Gehan) test, chi-square test and Fisher's exact test. The recurrence interval and survival time of the two groups were compared by non-parametric Wilcoxon rank sum test. Results The 2-and 3-year local recurrence rates in the laparoscopic group were both 3.0% and the overall local recurrence rate was 3.0% (3/99). The 2-and 3-year local recurrence rates in the open group were 2.6% and 4.0% , respectively, and the overall local recurrence rate was 3.5% (7/198), with no significant difference between the two groups (χ2 =0.002, P > 0. 05). The median survival time of patients with local recurrence was 15 months (range, 7-24 months) in the laparoscopic group and 11 months (range, 2-28 months) in the open group, with no significant difference between the groups (U = 15. 500, P >0. 05). The 1-year survival rate was 33.3% in the laparoscopic group and 42.9% in the open group. The 2-year survival rate was zero in the laparoscopic group and 42. 9% in the open group. There were no significant differences between the groups for the 1-and 2-year survival rates (χ2 =0.120, P>0.05). Conclusions The efficacy of laparoscopic radical resection for colorectal cancer is similar to that of open surgery. Laparoscopic radical resection for colorectal cancer is safe and feasible, and does not increase the recurrence rate of cancer.

Phthalate esters have been used as the plasticizers for about 80 years. As a kind of environmental hormone and universal pollutants, they are found widely in air dust, industrial waste water, river, soil and solid waste, moreover, they have been detected in food, drinking water and body fluid. In this paper, the new progresses of the effects of phthalate esters on the rodents and human, including reproductive toxicity and liver toxicity, were summarized and the short-term, quick and accumulative actions of phthalates mono-esters, metabolite of phthalate esters, on the rodents and human body were also reviewed.

Objectives To study the feasibility of total mesorectal excision (TME) by laparoscopy for rectal cancer.Methods The mesorectum in the resected samples and the number of lymph nodes resected were compared between laparoscopic (n=20) and open surgery group (n=20).Results ①The mesorecum of resected specimen was all complete in two groups. ②The lymph node yield (N 1) in laparoscopic and open group was 8.5?3.6 vs. 10.6?6.2(P=0.334), respectively. That in N 2 was 3.7?2.2 vs. 2.4?2.1(P=0.328). That in N 3 was 2.4?1.7 vs. 2.0?1.8(P=0.590).③The distal margin was all tumor-free in the two groups. ConclusionLaparoscopy is capable of performing TME in patients with rectal carcinoma undergoing radical resection.

Objective To evaluate the efficacy of transanal local resection for early low rectal cancer. Methods The clinical data of 72 patients with early low rectal cancer who had been admitted to Union Hospital of Fujian Medical University from January 1997 to April 2009 were retrospectively analyzed. Patients were divided into 2 groups, and they received transanal local resection (group A, n = 31) and radical resection (group B, n =41), respectively. Postoperative local recurrence and distal metastasis were analyzed by Fisher exact test, the survival was analyzed by life table method. The difference in survival between the 2 groups was analyzed by Wilcoxon test. Results Three patients were found to have surgical complications in group B, while no complication was detected in group A. The local recurrence was 6% (2/31) in group A and 0 (0/41) in group B (P < 0.05); the distal metastasis was 6% (2/31) in group A and 2% (1/41) in group B, with no significance difference between the 2 groups (χ~2 =0. 062, P >0.05). The 3- and 5-year survival rates were 93%, 87% in group A, and 95%, 91% in group B, with no significant difference between the 2 groups (χ~2 =0.099, 0.144, P >0.05). Conclusions The prognosis of patients with early low rectal cancer who received transanal local resection is similar to those who received radical resection. Transanal local resection is safe and feasible when the indications are strictly followed.

Objective To investigate an appropriate megavoltage computed tomography ( MVCT ) protocol to guide helical tomotherapy ( HT) for multiple metastases. Methods According to the location of target volume, 48 patients with multiple metastases undergoing HT were divided into head/chest group ( n=15), head/pelvis group (n=15), and chest/pelvis group (n=18). Each target volume received MVCT scans during the treatment. The obtained MVCT images were registered to CT images and the setup errors were recorded. The CTV?PTV margins were calculated. Comparison was made by paired t test. Results In the head/chest group, there was no significant difference in the setup error in x?axis between the head and chest (-0.15±1?25 vs. -0.21±2?34, P=0?71), while the head had significantly smaller setup errors in y?and z?axis than the chest (0.73±1?22 vs. 1.56±2?54, P=0?00;0.93±1?44 vs. 2.65±1?88, P=0?00). In the head/pelvis group, the head had significantly smaller setup errors in x?, y?, and z?axis than the pelvis (-0.16±1?31 vs. -1.29±3?72, P=0?00;0.81±1?34 vs. 3.20±3?90, P=0?00;1.24±1?75 vs. 5.49±2?80, P=0?00) . In the chest/pelvis group, there were no significant differences in setup errors in x?or y?axis between the chest and pelvis (-0.25± 2?90 vs. -0.22± 3?65, P=0?06;0.35± 3?60 vs. 0.38± 3?78, P=0?87), while the chest had a significantly smaller setup error in z?axis than the pelvis (1.95±2?81 vs. 3.35± 3?05, P=0?00) . In the three groups, the CTV?PTV margins of lower target volume were reduced in three dimensions after the correction of upper target volume, in which y?axis showed the largest reduction of CTV?PTV margins (5?13 vs. 4?01;9?17 vs. 8?30;8?52 vs. 7?13). Conclusions The setup error of individual target volume should not be used for correction of the overall setup error in HT for multiple metastases with isolated target volume. An MVCT protocol that provides image?based guidance for multiple target volumes is recommended.

To investigate the effects of unpredictable chronic mild stress and Xiaotan Jieyu Recipe (XTJYR), a compound traditional Chinese herbal medicine, on the behaviors of Walker 256 tumor-bearing rats and to explore the mechanism.

Objective To construct eukaryotic expression vector of human antimicrobial peptide LL-37 pPIC9-LL-37, and transform the plasmid pPIC9-LL-37 into P.pastoris GS115 to obtain the recombinant P.pastoris strains.Methods The full-length of antimicsobial peptide LL-37 gene was artificially synthesized by overlap extension method and was fused to pPIC9 and then the fused plasmid was transformed into E.coli DH5?.After analysis by PCR and sequencing,the plasmid pPIC9-LL-37 was transformed into P.pastoris.The colonies exhibiting the phenotype of His+Mut+ or His+Mut-were screened by means of MM and MD plates and the insertion was confirmed by PCR.Results The results of PCR and sequencing confirmed that the LL-37 gene was correctly inserted into pPIC9. The colonies of 10 His+Mut+ and 9 His+Mut-were obtained by means of MM and MD plates screening and were confirmed by PCR.Conclsion The recombinant P.pastoris strains containing LL-37 were successfully obtained.

Objective To explore the influence of albumin-activated renal tubular epithelial cells (RTECs)on peritubular capillaries in co-culture system and its potential mechanism. Methods Endocytosis of TRITC labeled bovine scrum albumin (TRITC-BSA) by HKC was detected by laser scanning confocal fluorescence microscope. HKC or HKC transfected with cubilin (endocytic receptor of albumin) siRNA or pre-treated with rotenone was incubated with albumin(20 g/L) for 24 h respectively. Fluorescence probe technique and spectrometry were applied for determination of intracellular superoxide anion O2-and H2O2 in supematant. Then, the albumin-aetivated-HKC, pretreated-HKC with cubilin siRNA or rotenone, was cultured with HUVEC for 24 h in co-culture system respectively. HUVEC proliferation was determined by MTT and cellular apoptosis was analyzed by flow cytometry. Tabular morphogenesis of endothelial cells was examinedby microscopy. Results TRITC-BSA uptake was obviously lower in HKC transfected with cubilin siRNA. Intracellular generation of O2-and H2O2 in culture supernatant was increased in dose-and time-dependent manner after stimulating with albumin. The levels of O2-and H2O2 were suppressed by cubilin siRNA and rotenone. In co-culture system, albumin-activated-HKC induced endothelial cells apoptosis and inhibited their capillary tubular morphogenesis. Pretreatment of HKC with cubilin siRNA or rotenone could suppress endothelial cells apoptosis and promote capillary tubular morphogenesis. Conclusions There may be a crosstalk between RTECs and peritubular microvascular endothelial cells in renal proteinurie diseases. The generation of ROS by albumin-activated RTECs may play an important role in this process.