Objective To evaluate the safety and efficacy of laparoscopitotal mesorectal excision (TME) with sphincter-preservation in the treatmenof low rectal cancerby using metanalysi.MethodThe electronidatabase(PubMed ,Medline ,Ov-id ,Cochrane Library ,Controlled TrialRegistry ,SinoMedCBM ,Wanfang Dat,CNKI ,VIP ,eal) were retrieved .The related litera-tureon the randomized controlled trail(RCTs) and the non-randomized controlled trails(non-RCTs) comparing laparoscopiver-sulaparotomy TME with sphincter-preservation fotreating low rectal cancepublished from January 2001 to Octobe2012 were collected .The RevMan5 .2 software waused to conducthe metanalysi.ResultTwelve studieincluding 1 508 patientwere included ,in which the laparoscopigroup had 781 caseand the laparotomy group had 727 case.The metanalysiresultshowed thacompared with the laparotomy group ,the laparoscopiTME(LTME) group with sphincter-preservation had significantly lesestimated blood loss[mean difference(MD)= -67 .13 ,95% confidence interval(CI) (-78 .74 ,-55 .51) ,P＜0 .01] ,longedistal resection margins[MD=0 .15 ,95% CI(0 .01 ,0 .29) ,P= 0 .04] ,earlieintestinal functional recovery [MD= -1 .16 ,95% CI (-1 .32 ,-1 .01) ,P＜0 .01] ,shortehospital stay [MD= -3 .99 ,95% CI (-5 .36 ,-2 .63) ,P＜0 .01) ,lestotal morbidity [oddratio(OR)=0 .40 ,95% CI (0 .25 ,0 .63) ,P＜0 .01] ,anastomotileakage[OR=0 .60 ,95% CI (0 .37 ,0 .96) ,P=0 .03] ,urinary re-tention[OR=0 .40 ,95% CI(0 .18 ,0 .87) ,P=0 .02] and incision infection[OR=0 .26 ,95% CI(0 .11 ,0 .61) ,P=0 .002] .The statis-tically significandifferencewere nofound between the two groupin the numbeof lymph node dissection,length of resected specimen ,postoperative obstruction and the 2-yeaoverall survival rate(P＞0 .05) .Conclusion LTME with sphincter-preservation fotreating low rectal cancehathe advantageof lessurgical traum,rapid postoperative recovery and few complication.Never-theles,iineeded to conducfurtheresearch fovalidating whetheLTME with sphincter-preservation having the superiority in the aspectof postoperative anal function recovery and long-term outcome .

Antigens, Neoplasm ; genetics ; metabolism ; Breast Neoplasms ; enzymology ; genetics ; metabolism ; DNA Topoisomerases, Type II ; genetics ; metabolism ; DNA-Binding Proteins ; genetics ; metabolism ; Female ; Gene Expression Regulation, Neoplastic ; physiology ; Humans

Animals ; Heparin ; pharmacology ; Humans ; Ligands ; Lymphatic Metastasis ; Neoplasm Invasiveness ; Neoplasm Metastasis ; Neoplasms ; metabolism ; pathology ; Oligosaccharides ; metabolism ; Selectins ; metabolism ; physiology ; Signal Transduction

Acetyltransferases ; genetics ; Breast Neoplasms ; genetics ; Female ; GPI-Linked Proteins ; Gene Expression Regulation, Neoplastic ; genetics ; Humans ; Membrane Glycoproteins ; genetics ; Neoplasm Metastasis ; genetics ; physiopathology ; S100 Proteins ; genetics ; Transcription Factors ; genetics

Cell Movement ; drug effects ; Chemokine CXCL12 ; genetics ; metabolism ; pharmacology ; physiology ; Humans ; Neoplasm Invasiveness ; physiopathology ; Neoplasm Metastasis ; physiopathology ; Neoplasms ; metabolism ; Neovascularization, Pathologic ; physiopathology

Objective To discuss the value of 256 spiral CT dynamic volume scanning in the diagnosis of moyamoya disease.Methods Twenty-three patients with moyamoya disease undergoing 256 spiral CT dynamic volume scanning (moyamoya group) were selected,and 18 patients having cerebrovascular disease symptoms,but the brain artery without stenosis (control group) were also selected.The volume reconstruction (VR),maximum intensity projection (MIP) and cerebral CT perfusion imaging was displayed.The cerebral CT perfusion imaging parameters of anterior,middle,posterior cerebral artery were measured and analyzed.Results VR,MIP could well reproduce lesion location,degree of stenosis and skull base abnormal vascular network change.Compared with control group,the cerebral blood volume (CBV) was increased [(8.46 ±0.91) ml/100 g vs.(2.92 ±0.72) ml/100 g],time to peak (TTP) was increased [(30.27 ±5.02) s vs.(24.83 ±4.07) s] in anterior cerebral artery,and there was significant difference (P ＜ 0.01),but there was no significant difference in the cerebral blood flow (CBF),the mean transit time (MTT)(P ＞ 0.05).Compared with control group,CBV was increased [(8.06 ± 1.05) ml/100 g vs.(6.08 ± 0.56) ml/100 g],MTT,TTP was increased [(6.34 ± 1.01) s vs.(3.83 ± 0.83) s,(32.06 ± 2.55) s vs.(25.83 ± 2.34) s] in middle cerebral artery,and there was significant difference (P＜ 0.01),but there was no significant difference in CBF (P ＞ 0.05).Compared with control group,there was no significant difference in the cerebral CT perfusion imaging parameters of posterior cerebral artery (P ＞0.05).Conclusion 256 spiral CT dynamic volume scanning can be combined with morphology and function imagings,and has important guiding significance for diagnosis of moyamoya disease.

Objective:To discuss the relationship between the serum level of interleukin-6 (IL-6) and the presence of an intrauterine contraceptive device (IUCD). Methods:The experimentalgroup was subdivided into the bleeding and the non-bleeding groups which consisted of 64 womenwith IUCD. There were 60 healthy women in the control group. The serum levels of IL-6 and C-reactive protein (CRP) were detected by enzyme-linked immunosorbent assay (ELISA) in bothgroups. Results :In the experimental group,the serum levels of IL-6 in 3 cases were increased,andthere was a significant difference in comparison with those of the control group (P＜0. 01),butthere were no statistical differences between the bleeding group and the non-bleeding group withIUCD (P＞0． 05). Serum CRP was negative both in the experimental groups and in the controlgroup. Conclusion:The non-bacterial endometrial inflammation induced by IUCD causes the in-crease of serum level of IL-6 in some women. It is suggested that IL-6 may play an important rolein the contraceptive mechanism of IUCD.

Aim To investigate the protective effect of pituitary adenylate cyclase activating polypeptide(PACAP)on focal cerebral ischemia reperfusion injury in rats.Methods The models of focal cerebral ischemia reperfusion in rats were established with suture-occluded method to simulate the middle cerebral artery ischemia reperfusion injury in clinic.The treatment groups were given three different dose PACAP(PACAP 10-11 mol,PACAP 10-10 mol and PACAP 10-9 mol) in 15 minutes before cerebral ischemia.PACAPs were infused into lateral cerebral ventricle by microinjector.The water content of brain,the activity of superoxide dismutase(SOD),the content of malondialdehyde(MDA) and the content of nitrogen monoxidum(NO) of the brain tissue were determined.Results Compared with NS group,the water content of brain and the concentration of MDA and NO were obviously lower in each PACAP treatment group,while the activity of SOD was elevated to different degrees.Conclusion PACAP has an obvious protective effect on ischemia-reperfusion injury of focal brain tissue in rats,in which edema-alleviating,free radicals-scavenging and lipid peroxidation-attenuating could be involved.The protective effect seems to be more clear in middle-and high-dose group than in low-dose group.

A new minimally invasive gallbladder-preserving operation has emerged for the treatment of gallbladder stones,but fundamentally it is a replica of the previous gallbladder preservation method.The gallbladder aids in digestion but is not essential for life.Its function should not be exaggerated and should not instigate trivial reasons for its preservation.Most patients undergoing cholecystectomy maintain a good quality of life.The causes,mechanisms,and prevention of gallstone formation remains mysterious,so a high recurrence rate after gallbladder-preserving operation is difficult to avoid.A full cholecystectomy can avoid recurrence complications and the benefits outweigh the risks.A discussion of the benefits and complications must be initiated to evaluate both treatment modalities for gallstones.