Objective To evaluate the value of double stapling technique with curved cutter stapler in colorectal anastomosis,especially in low colorectal anastomosis. Methods The clinical data of 168 cases of rectal carcinomas treated with double stapling technique with curved cutter stapler were retrospectively reviewed.The intraoperative condition,postoperative complications and findings during follow up were analysed. Results During the operations,the processes of closure and anastomosis of all the patients were satisfactory,and no operative death occurred.After the operations,4 cases(2.4%) had anastomotic leakage,3 cases(1.8%) had anastomotic bleeding,and 2 cases(1.2%) had rectovaginal fistula.All the complications were cured.There was no anastomotic stricture. Conclusion Double stapling technique with curved cutter stapler may help to accomplish low colorectal anastomosis which is a difficult task for handed suture.

Objective:To investigate the effect of perineural invasion (PNI) on patients with early squamous cell carcinoma of the tongue (ESCCT) and the controversial issues related to PNI's effect on loco-regional recurrence, cervical lymph node metastases, and prognosis. Methods:Data of 156 patients with ESCCT were analyzed. Two subgroups comprising 40 patients each were investigated. One was PNI-positive subgroup, and the other subgroup was consisted of patients with PNI-negative carcinomas. These patients had similar histopathological characteristics and were randomly selected from the total number of cases. The relationship among the prevalence of PNI, loco-regional recurrence, cervical lymph node metastases, and prognosis was analyzed. Results:PNI was significantly correlated with high cervical lymph node metastases and poor 5-year survival rates (P=0.045 and P=0.034, respectively) but not with local recurrence (P=0.531). Elective neck dissection was considerably associated with a low risk of regional recurrence among the PNI-positive ESCCT patients (P=0.001). Conclusion:PNI should be considered as a predictor for high cervical lymph node metastases and poor 5-year survival of early tongue squamous cell carcinoma. Elective neck lymph node dissection should be performed among patients with PNI-positive early tongue squamous cell carcinoma.

Objective To evaluate the influence of peritoneal transport characteristics on nutritional status of peritoneal dialysis patients and estimate the role of peritoneal transport characteristics and nutritional status in evaluation of peritoneal dialysis adequacy. Methods Peritoneal transport properties (D/Pcr) were evaluated by Short Peritoneal Equilibration Test and then 53 cases were divided into high transport group (D/Pcr ≥0. 65) and low transport group (D/Pcr < 0. 65). Urea kinetics (Kt/v) and total clearance of creatinine (TCcr) were calcu- lated. Serum albumin (ALB), prealbumin, transferring (TF), hemoglobin (Hb), lean body mass (LBM) and LBM% were examined or calculated. Subjective global assessment (SGA) was used to evaluate the nutritional sta- tus of patients. Results There were 30 cases in high transport group and 23 cases in low transport group. D/Pcr (0. 82±0.15 vs. 0. 55±0. 08, P < 0. 01), TCcr (62. 93%±25. 98% vs. 49. 69%±16. 92% , P < 0. 05) and age were significantly higher in high transport group than those in low transport group, while ALB, TF, Hb, LBM% , and SGA were significantly lower than those in low transport group (P < 0.05). ALB was negatively cor-related with Kt/v (r= -0.2708, P<0. 05). Conclusions High peritoneal transport patients have better solute clearance but worse nourishment status compared with low transport ones. Nutritional status is one of the factors to evaluate dialysis adequacy. Nutrition management and guidance should be strengthened for the continuous ambula- tory peritoneal dialysis patients, especially for the elderly ones.

Objective To study the effects of γ-IFN on the expression of HLA-G mRNA in primary cultured astrocytoma cells. Methods Different concentrations of γ-IFN were added to primary cultured cells, and HLA-G mRNA were detected by RT-PCR. Results After γ-IFN treatment, HLA-G mRNA can not be determined from HLA-G originally negative astrocytoma cells. The expression of HLA-G are up - regulated in all original HLA-G positive astrocytoma cells in a dose-dependent manner. Conclusion γ-IFN can increase the ex-pression of HLA-G gene in the primary cultured astrocytoma cells which HLA - G are originally positive.

Objective To construct a fusion protein that used for treatment of resistance and palindromia in leukemia and studied its biological activity. Methods IL-3 and LP gene fragments were amplified by PCR. After enzymatic digestion and T4 ligation, the fusion gene was cloned into expression vector pAYZ. The product was purified by exchange chromatography and anti-Etag affinity chromatography. IL3-G4SLP fusion protein was analyzed by SDS-PAGE and Western blot. Protein biological activity was detected by FACS. Results The fusion protein was expressed as soluble protein by E.Coli 16C9. The protein expression level was about 1 mg/L, its purity was over 95 %, and the expression level was about 1 mg/L. The fusion protein can combined specificely with CD123 on leukemia stem cells. Conclusion Fusion protein IL-3-G4S-LP can target on leukemia stem cells and maybe as a potential drug used for treatment of resistance and palindromia in leukemia.

Objective To study the prevention and cure effect of immunoregulation therapy on postoperative infectious complications of calculous obstructive jaundice.Methods Prospective,randomized,blind and controlled clinical analysis of 40 patients conforming to the standard of calculous obstructive jaundice was carried out.The patients were divided into two groups at random.One was control group (n=20) with regular therapy,and the treatment group (n=20) with ulinastatin plus thymosin-α1 on the base of regular therapy for 1 week.The immunological indexes were determined before and after therapy on the 1st,3rd,5th、7th and 14th day,including the changes in lymphocyte count,CD14+ monocytes human leukocyte antigen (locus) DR (HLA-DR),and the incidence of postoperative infection were observed.Results The incidence of postoperative infectious complications in treatment group (10％) was remarkable lower than that in control group (30％,P＜0.01).There was significant difference between two groups (P＜0.05).After the 3rd,up to 14th day of therapy,the counts of lymphocyte and CD14+ monocytes HLA-DR were significantly higher than those in control group (all P＜0.05).Conclusions Immunoregulation therapy can improve the prognosis of obstructive jaundice patients in a period of 14 days of observation,and lymphocyte counts and CD14+monocytes HLA-DR were increased significantly,showing that immuno suppression can be ameliorated.Immunoregulation therapy could effectively prevent infectious complications of calculous obstructive jaundice.

Objective To investigate the significance of orthotopic liver transplantation in the management of primary hepatocellular carcinoma (PHC) ; To evaluate the survival and prognostic factors of liver transplantation for PHC.Method The clinical data from 194 consecutive PHC patients who underwent OLT were retrospectively analyzed.Result The 1-,3-and 5-year cumulative survival rate of the 194 patients was 92.78％,78.07％ and 76.80％ respectively.There were 37 cases of recurrence or metastasis of the tumor with the incidence rate being 19.1％ (37/194).The tumor TNM stage (P=0.026 667),tumor diameter (P =0.0045),tumor number (P =0.0318),vascular invasion (P =0.006 059),and AFP level before transplantation (P =0.003 426) were significantly related with tumor recurrence.Multivariate analysis revealed that tumor diameter (P =0.0081,OR =0.789,95％ CI:2.1233-6.124),vascular invasion (P＜0.001,OR =5.928,95 ％ CI:1.173-86.789),and AFP level before transplantation (P =0.019,OR =2.601,95％ CI:2.196-5.658) were independent risk factors for tumor recurrence.There was statistically significant difference in survival rate and tumor-free survival rate between Milan criteria group and beyond-UCSF criteria group (P＜0.01),and between UCSF criteria group and beyond-UCSF criteria group (P＜0.01).There was no significant difference in survival rate and tumor-free survival rate between Milan criteria group and UCSF criteria group (P ＞0.05).Conclusion Liver transplantation is an effective treatment for PHC.The tumor diameter ＞8 cm,vascular invasion and AFP level significantly affect the survival of PHC patients.

Objective: To explore the mechanism of all-transretinoic acid (ATRA) increasing retinoblastoma (RB) sensitivity to vincristine, and the inhibiting effect of vincristine combined with ATRA treatment on the SO-RB50 cell proliferation. Methods: SO-RB50 cells were cultivated by routine culture method. Different concentrations of vincristine or ATRA were added into culture solution. After 48 h, cell counting kit-8 was used to detect the median inhibitory concentration (IC

Objective To compare the clinical efficacy of subinguinal microsurgical and single -port laparoscopic high ligation in the treatment of varicocele.Methods 218 patients with varicocele were enrolled in this study.According to the digital table,they were randomly divided into two group.148 cases were treated by subinguinal microscopic varicocelectomy(microscopic group),70 cases were treated by single -port laparoscopic high ligation varicocele(single -port laparoscopic group).Postoperative follow up was 3 -24months.The operative duration,length of hospital stay,hospitalization expense,postoperative complications and semen quality parameters were compared between the two groups.Results There were statistically significant differences in operative duration and hospitalization expense between the two groups(all P <0.05).There was no statistically significant difference in length of hospital stay (P >0.05).In the 218 followed -up patients,the sperm concentration and motility (grade a + b sperm)all significantly improved,which of the microscopic group and single -port laparoscopic group preoperation were (19.1 ± 8.2)×106 /mL,(18.2 ±7.9)×106 /mL and (22.7 ±7.8)%,(21.6 ±8.9)% respectively,which at 3 -6 months after operation were (56.2 ±10.8)×106 /mL,(45.8 ±12.9)×106 /mL and (58.8 ±9.7)%,(44.6 ±10.7)%, there were statistically significant differences compared with preoperation (t =6.227,9.579,all P <0.05 ). Conclusion The surgical methods in the treatment of varicocele can improve the quality of patients,but microscopic group is obviously better than single -port laparoscopic group in improvement of semen quality parameters,safety, patient -based compliance and economy.

Objective To explore the clinical efficiency and safety of radiofrequency ablation combined with Tegafur,Gimeracil and Oteracil Porassium Capsules( S-1 capsules) for hepatocellular carcinoma.Methods Sixty HCC patients included in this study were underwent initial radiofrequency ablation and then they were di-vided into RFA+S-1 group and RFA control group according to the metronomic chemotherapy either with S-1 or not.The local tumor control and disease free survival outcome between the two groups were compared.Results Follow-up observation showed that the total control rate after 9 months′treatment was 93.3%in RFA+S-1 group vs.73.4%in RFA control group(P=0.038).During the 18 months of follow up,the median time for dis-ease free survival was 16.25 months in RFA+S-1 group vs.12.25 months in RFA control group( P<0.001) . One-year progression free survival rate in RFA group was 53.3%,which was significantly lower than the RFA+S-1 group(83.3%)(P=0.012).The major complication rate was 13.3%.No procedu rerelated death or severe complications occurred.Conclusion Metronomic chemotherapy with S-1 following initial radiofrequency ablation delays tumor progression and prolongs overall survival of patients with HCC tumors.