Objective To investigate the surgical techniques and clinical efficacy of laparoscopic intersphincteric resection (ISR) in the treatment of low rectal cancer.Methods A retrospective descriptive study was performed.The clinical data of 12 patients who underwent laparoscopic low rectal anterior resection combined with ISR at the First Affiliated Hospital of Dalian Medical University from May 2014 to October 2014 were collected.The patients underwent abdominal operation including total mesorectal excision (TME) + sphincter mobilization,then transanal intersphincteric resection,finally colinic anal-anal anastomosis.The operation time,volume of intraoperative blood loss,number of lymph node dissected,postoperative complications,time to anal exsufflation,duration of hospital stay,duration of postoperative hospital stay,pathological stage and follow-up were observed.The patients were followed up by outpatient examination and telephone interview at month 1,3 and 6 after operation up to April 18,2015.The follow-up included the prognosis of patients and the recovery of anal function.The function of defecation was evaluated by Wexner scoring system and Kirwan grading.Measurement data with normal distribution were presented as (x) ± s.Results All the 12 patients were completed laparoscopic surgery without conversion to open surgery.Eight patients underwent partial internal anal sphincter resection,and 4 underwent subtotal resection.Four patients in T3 stage underwent lateral lymph node dissection preserving the left colonic artery,hypogastric nerve and pelvic nerve.The operation time was (290 ± 35) minutes.The volume of intraoperative blood loss was (124 ± 80) mL.The number of lymph nodes dissected was 17 ± 8,and the number of positive lymph nodes was 0-4.The distance of the distal margin was (2.0 ± 0.5) crm,and the margin was negative.All the 12 patients were not complicated with infection,bleeding,anastomotic leakage,anastomotic stenosis and other complications.The time to postoperative anal exsufflation was (3 ± 1)days,duration of hospital stay was (20 ± 3) days,and duration of postoperative hospital stay was (12 ± 3) days.The results of TNM stage showed 3 cases of pT1 stage,5 cases of pT2 stage,4 cases of pT3 stage,10 cases of pN0 stage,1 case of pN1 stage,1 case of pN2 stage,8 cases of Ⅰ stage,2 cases of Ⅱ stage and 2 cases of Ⅲ stage.All the 12 patients were followed up for 6-11 months.The defection frequency and the Wexner score at month 1,3 and 6 after operation were 12 ±7,15 ±3,9 ±5 and 13 ±4,5 ±3,10 ±3,respectively.Of the 12 patients,the number of patients with satisfactory Kirwan score,flatus incontinence and loose stool was 1,3,8 at month 1 after operation,3,3,6 at month 3 after operation,10,2,0 at month 6 alter operation,respectively.Conclusion Laparoscopic ISR is effective in the treatment of low rectal cancer.

Reduced surgery for early gastric cancer has been actively performed because it can offer complete cure and a good postoperative quality of life.Pylorus-and vagus-preserving gastrectomy (PPG) is one form of function-preserving surgery.Laparoscopic surgery has been widely applied for the treatment of gastric cancer due to its advantages including low invasiveness,minimal bowel paralysis,earlier postoperative healing and nerve and gastric function preservation.Therefore,laparoscopic pylorus-and vagus-preserving gastrectomy (LAPPG) for the treatment of early gastric cancer is welcomed by surgeons.From May 2004 to April 2013,12 patients with early gastric cancer received LAPPG in the First Affiliated Hospital of Dalian Medical University.All the patients were followed up for 3-74 months.One patient died of gastric cancer liver metastasis at postoperative month 22.The 5-year cumulative survival rate was 86％.LAPPG preserves nerve function and limits surgical injury,it is one of the ideal surgical methods for the treatment of early gastric cancer.

There is a variety of gut microbiota in human body, which is closely associated with the health and disease. Normal gut microbiota can produce colonization resistance to pathogens. Antibiotics can affect the composition of gut microbiota and change the intestinal microenvironment, resulting in intestinal microecological disorders, which in turn cause intestinal pathogenic infections and other diseases. In this paper, the concept of intestinal microecology, the mechanism of intestinal colonization resistance, the effect of antibiotics on intestinal microecology, and the treatment methods were reviewed, aiming to provide the information for the rational use of antibiotics and the development of more effective treatment methods to maintain the stability of intestinal microecology.

Adolescent ; Child ; Child, Preschool ; Humans ; Infant ; Infant, Newborn ; Rickets ; prevention & control ; Vitamin D ; therapeutic use

Adolescent ; Adult ; Anemia, Hemolytic, Autoimmune ; drug therapy ; Female ; Humans ; Immunosuppressive Agents ; therapeutic use ; Male ; Middle Aged ; Sirolimus ; therapeutic use ; Treatment Outcome ; Young Adult

iple occurrence of the tumor, which can decline its recurrence and postpone its progression.

Child ; Graft Survival ; HLA Antigens ; genetics ; immunology ; Hematopoietic Stem Cell Transplantation ; Humans ; Polymerase Chain Reaction ; Tissue Donors ; Transplantation Chimera ; genetics ; Transplantation Conditioning ; methods ; Transplantation, Homologous ; immunology

With the support of World Bank ( WB ) and UK Department for International Development ( DFID) , China Rural Health Project ( hereinafter referred as Health XI Project) began to introduce the idea of performance management to 40 counties in 8 provinces in 2008 . The project implemented cyclic performance manage-ment strategies, including performance planning, performance communication, performance evaluation and perform-ance improvement. With the continuous improvement of performance as the goal, the project attempted to establish incentive mechanisms based on the performance of health care services. After five years of pilots in 40 counties, it has achieved good results in the aspects of improving the quality and efficiency of health care services, motivating the enthusiasm of health care managers and workers, etc. Moreover, it has successfully built several advanced counties with exemplary performance management and accumulated some experience, which provides reference and demonstra-tion for implementing performance management in other areas. The key experiences of implementing performance management of rural primary health care include taking health care quality as the core of performance, appropriately combining economic and non-economic incentives, encouraging personnel participation in performance management in order to ensure the sustainability of performance improvement, and effectively applying the ideology of systematic per-formance management in order to effectively enhance the management level of hospitals. The paper also puts forward some policy suggestions based on emerging issues during implementation of performance management.

Objective:To observe the clinical effect of wind-expelling method of acupuncture and Chinese herbs for sudden deafness.
Methods:A total of 90 cases with sudden deafness were randomly divided into three groups based upon their visit order and random digital table, an acupuncture plus Chinese herbs (APCH) group, an acupuncture group, and a Western medication (WM) group, 30 cases in each group. The APCH group was treated by puncturing Fengchi (GB 20), Fengfu (GV 16) and Fengmen (BL 12), without retaining the needles, and then by puncturing Zhongwan (CV 12), Guanyuan (CV 4), Qihai (CV 6) and Tianshu (ST 25) with reinforcing technique after arrival of the needling sensation, and the needles were retained for 30 min, plus oral administration of wind-expelling Chinese herbs. The acupuncture group was treated with the acupoints selected by syndrome differentiation in reference to the textbook of Acupuncture and Moxibustion Science. The WM group was treated by intravenous infusion of Alprostadil injection, Adenosine Disodium Triphosphate and Coenzyme A and muscular injection of Vitamin B12 and Vitamin B1. The decibel values of hearing loss before and after treatment were respectively recorded and analyzed comparatively.
Results:In the intra-group comparison after treatment among the three groups, the decibel values of hearing loss all declined, with statistically significant differences (allP<0.05). After treatment, the decibel value of hearing loss in the APCH group was better than those in the acupuncture group (P<0.05) and the WM group (P<0.05). The total effective rate was respectively 83.3% in the APCH group, 60.0% in the acupuncture group and 56.7% in the WM group. The total effective rate in the APCH group was better than those in other two groups (bothP<0.05).
Conclusion:The therapeutic effect was better for sudden deafness by wind-expelling method of acupuncture and Chinese herbs than by acupuncture alone or by Western medication.

Female ; Humans ; Labyrinth Diseases ; Middle Aged ; Semicircular Canals ; Syndrome