Objective To investigate the clinical efficacy of ligation of intersphincteric fistula tract (LIFT) for the treatment of high anal fistula.Methods The clinical data of 77 patients with high anal fistula who were admitted to the Puren Hospital and Chaoyang Hospital from January 2011 to June 2012 were retrospectively analyzed.All the patients were treated using the LIFT method (LIFT group,37 patients) or fistulectomy + threaddrawing therapy (thread-drawing group,40 patients).The operation time,healing time,time and severity of postoperative pain,recurrence and anal sphincter dysfunction were compared between the 2 groups.The measurement data,the count data and the rank data were analyzed using the t test,chi-square test,and the rank sum test,respectively.Results The operation time of the LIFT group and the thread-drawing group were (21.4 ± 2.0) minutes and (20.6 ± 1.9) minutes,with no significant difference between the 2 groups (t =1.911,P ＞ 0.05).In the LIFT group,17 patients felt low-grade pain,no patient felt medium-grade or severe pain.In the thread-drawing group,7 patients felt low-grade pain,14 patients felt medium-grade pain,19 patients felt severe pain.The duration of postoperative pain in the LIFT group and the thread-drawing group were (3.0 ± 1.3) days and (14.1 ± 1.5)days,respectively.The severity and duration of postoperative pain of the LIFT group were significant lower and shorter than those of the thread-drawing group (u =-7.189,t =34.534,P ＜ 0.05).The healing time,anal scar area and anal sphincter function score were (26.0 ± 1.9) days,(1.24 ± 0.20) cm2 and 1 in the LIFT group,and (40.7 ± 2.8) days,(2.64 ± 0.25) cm2 and 4 in the thread-drawing group,with no significant difference between the 2 groups (t =26.574,26.868,Z =-7.513,P ＜ 0.05).The effective rate of the 2 treatment methods were 100％.The cure rate and recurrence rate were 51.4％ (19/37) and 5.4％ (2/37) in the LIFT group,and 42.5％ (17/40) and 2.5％ (1/40) in the thread-drawing group.There were no significant differences in the cure rate and recurrence rate between the 2 groups (x2=0.605,0.433,P ＞ 0.05).Conclusion LIFF method has higher cure rate for high anal fistula with short time of postoperative pain and healing,good anal sphincter function and low recurrence rate.

Objective To study the effects of lactate peritoneal dialysis solution(L-PDS) with different concentrations on apoptosis of human peritoneal mesothelial cells(HPMC),the expressions of bcl-2,bax and activity of caspase-3.Methods HPMC were separated using enzyme digestion and cultivated stably in vitro.After HPMC were co-cultivated with different concentrations(1.50%,2.50%,4.25%) L-PDS,flow cytometry was used to test the apoptosis of HPMC,RT-PCR was used to observe the expressions of bcl-2 and bax,fluorometric method was used to detect the activity of caspase-3.Results Compared with control group, L-PDS could induce the apoptosis of HPMC,especially in high concentration.With the increasing of L-PDS concentration,the expression of bcl-2 mRNA decreased,the expression of bax mRNA increased,the activity of caspase3 raised.There were significant differences of the indexes mentioned above between 4.25%,2.50% L-PDS groups and control group(P0.05).Conclusion L-PDS could induce HPMC apoptosis,which may be executed by alternating of the expressions of bcl-2,bax and activating of caspase3.

Objective To evaluate complications from two anal stapling operations of anorectal surgery,the procedure for prolapse and hemorrhoids (PPH) and the stapled transanal rectal resection (STARR).Methods The data of 1 276 patients undergoing PPH for hemorrhoids and 149 patients having STARR for ODS from January 2010 to January 2015,in Beijing Chaoyang Hospital were studied.More than six months of follow-up was done.Statistics used included t Test and Chi-square test,Logistic regression analysis.Results Complications of PPH and STARR included hemorrhage in 27 cases (2.1％) vs.3 cases (2.0％);pain in 285 cases (22.3％) vs.6 cases (4.0％);uroschesis in 96 cases (7.5％) vs.12 cases (8.1％);edema in 227 cases (17.8％) vs.16 cases (10.7％);defecatory urgency in 194 cases (15.2％) vs.38 cases (25.5％);anastomotic infection in 17 cases (1.3％) vs.2 cases (1.3％);mild anal incontinence in 11 cases (0.9％) vs.2 cases (1.3％);anastomotic stenosis in 11 cases (0.9％) vs.1 case (0.7％).There was a positive correlation between dry stool,defecatory urgency and hemorrhage after PPH.PPH compared to STARR:The post-operative pain,edema and defecatory urgency and overall complication rate was significantly different (t =26.51,x2 =4.69,x2 =10.38,x2 =37.12,P ＜ 0.05).Conclusions PPH and STARR have rare serious complications and easy to handle.Abnormal defecation such as dry stool and defecatory urgency is an important risk of hemorrhage.

Objective To investigate the effects of penehyclidine hydrochloride (PHCD) pretreatment on β-arrestin-1 expression during sepsis-induced acute lung injury in mice.Methods Thirty female Kunming mice,weighing 18-20 g,were randomly divided into 3 groups (n =10 each):sham operation group (S group),sepsis group (CLP group) and PHCD group.Sepsis was induced by cecal ligation and puncture (CLP).In PHCD group,PHCD 0.45 mg/kg was injected intraperitoneally 1 h before CLP.The equal volume of normal saline was given instead in groups S and CLP.The mice were sacrificed at 12 h after CLP,bronchoalveolar lavage fluid (BALF) was collected for measurement of the total protein concentration,and the lungs were removed for determination of wet/dry lung weight ratio and expression of myosin light chain kinase (MLCK),vascular endothelial cadherin (VE-cad-herin) and β-arrestin-1 in lung tissues.The pathological changes of the lung were scored.Results Compared with group S,the lung injury score,wet/dry lung weight ratio and total protein concentration in BALF were significantly increased,MLCK expression was up-regulated and VE-cadherin expression was down-regulated in groups CLP and PHCD,β-arrestin-1 expression was down-regulated in group CLP and β-arrestin-1 expression was up-regulated in group PHCD (P ＜ 0.05 or 0.01).The lung injury score,wet/dry lung weight ratio,total protein concentration in BALF,and MLCK expression were significantly lower,while the expression of VE-cadherin and β-arrestin-1 was higher in PHCD group than in CLP group (P ＜ 0.05 or 0.01).Conclusion PHCD pretreatment can ameliorate acute lung injury through up-regulating β-arrestin-1 expression and reducing microvascular permeability in septic mice.

Objective To evaluate the efficiency of amifostine in protecting against oral and gastrointestinal mucositis in hematologic malignancies patients with high-dose total body irradiation following the hematopoietic stem cell transplantation,and assess the hematologic recovery as well as the potential side effect of amifostine.Methods Thirty-two hematologic malignancies patients underwent hematopoietic stem cell transplantation in our institution from 2012 to 2016 were retrospectively analyzed.All of them were treated with total body irradiation (700-1 200 cGy) and high-dose chemotherapy,in which 14 patients received 400 mg amifostine before radiotherapy.Prior institutional experience in 18 patients treated without amifostine was used as a historical comparison (no-amifostine group).Results Severe oral mucositis occurred in 14.3％ of patients in the amifostine group while 77.2％ in the no-amifostine group (x2 =10.62,P ＜0.05).Total parenteral nutrition was used in 21.4％ of amifostine group and 38.8％ in noamifostine group (P ＞ 0.05).The rates of grade 2 and 3 gastrointestinal mucositis were 35.7％ and 61.5％ in amifostine group,while in no-amifostine group the rates were 33.3％ and 66.7％,respectively (P ＞ 0.05).No significant difference was found in engraftnent times of granulocyte and platelet.No amifostine related side effects were observed.Conclusions The combination of amifostine and total body irradiation conditioning therapy during hematologic stem cell transplantation might reduce the severity of oral mucositis.The utilize of amifostine has no obvious effect on hematopoietic recovery and can be well tolerated.

Objective To investigate the prognosis of local resection in patients with low rectal cancer, and assess surgical indications for this procedure. Methods One hundred and twenty-four patients with low rectal cancer from Jan 1975 to Dec 2006 were analyzed, the clinicopathologic features and surgical, outcome were examined as prognostic factors. Survival rate was estimated by Kaplan-Meier method and compared by Log-Rank test, prognostic factors were analyzed by multivariate COX proportional hazards model. Results The 5-year survival rate of 124 patients underwent local resection was 90.7 %(97/107), there were 4.8 %(6/124) patients with complications and 15.3 %(19/24) ones with local recurrence.The infiltration, vascular invasion, the size of tumor and the histological grade were significant prognostic factors of overall survival, but gender, age, the tumor site and the macroscopic type were not. Multivariate analysis indicated that the tumor infiltration were independent poor prognostic factor. Conclusion Local resection is suitable for Tis and T1 low rectal cancer, and those with high local recurrence factors should undergo radical resection. Strict follow-up and adjuvant therapy is necessary for local excision.

To find a rapid and accurate genotyping method for specific non-syndromic hearing loss (NSHL)-causing gene mutations for disease diagnosis in different ethnic populations.Methods We performed a novel multiplex primer extension (PE) reaction in combination with denaturing high-performance liquid chromatography (DHPLC) to simultaneously detect and genotype the 6 most common mutations in 180 patients with NSHL (GJB2-235delC,GJB2-299delAT,PDS-A2168G,PDS IVS7-2A ＞ G,mtDNA-A1555G,and mtDNA-C1494T) in Chinese population.This method involved the amplification of the target sequence,followed by a purification step,a multiplex PE reaction,and DHPLC analysis performed on the Transgenomic Wave DNA fragment analysis system under fully-denaturing conditions.Results In a blind analysis,this technique successfully and accurately genotyped 100％ of the samples simultaneously characterized by direct sequencing.Conclusion Combination of PE and DHPLC is simple,rapid,accurate,and cost-effective for genotyping common disease-causing mutations,including substitutions,insertions,and deletions in NSHL,and may be successfully used in other genetic diseases.

Objective To assess efficacy and safety of enhanced rehabilitation program for patients with colorectal cancer surgery. Methods One hundred and ten consecutive patients admitted to general surgery department at Beijing Chaoyang Hospital during October 2007 to October 2009 undergone with fasttrack colorectal cancer surgery and enhanced rehabilitation were prospectively studied, with 117 patients undergone with same colorectal cancer surgery by traditional perioperative treatment during May 2005 to September 2007 as controls. Restoration of their gastrointestinal function, occurrence of complications, fatality and length of hospital stay after surgical operation were observed in the group of enhanced rehabilitation and control group. Results Demographic characteristics, stage classification of illness and surgical operation methods were comparable in both groups. The first day with air discharge from the flux was earlier in enhanced rehabilitation group than that in controls (2. 5 vs. 3. 5 day after surgery, P ＜ 0. 05 ), and the former could tolerate solid food earlier than the latter (6.0 vs. 6.7 days after surgery, P=0.028). Overall morbidity of complications was less in the group with enhanced rehabilitation than that in controls (23.6% vs. 39. 3%,P =0. 011 ) and shorter length of hospital stay was observed in the former than that in the latter (9. 0 vs. 10. 8 days after surgery, P =0. 041 ). There was no difference in mortality, incidence of anastomotic leakage, and infectious and non-infectious complications between the two groups. Conclusions Enhanced rehabilitation program is safe and effective following colorectal cancer surgery to accelerate restoration of gastrointestinal function, reduce complications and shorten hospital stay after colorectal cancer surgery.

Objective To investigate the effects of penehyclidine hydrochloric(PHC)pretreatment on the expression of β-arrestin-2 in the lung tissue in sepsis-induced acute lung injury in mice.Methods Thirty female Ktmming mice,aged 6 weeks,weighing 18-20 g,were randomly divided into 3 groups(n =10 each):sham operation group(group S); sepsis group(group CLP)and penehyclidine hydrochloric pretreatment group(group PHC).Sepsis was induced by cecal ligation and puncture(CLP)in groups CLP and PHC.Penehyclidine hydrochloric 0.45 mg/kg was injected intraperitoneally at 1 h before CLP in group PHC.While the equal volume of normal saline was given instead of penehyclidine hydrochloric in groups S and CLP.At 12 h of CLP,the animals were sacrificed,and the lung tissues were removed for determination of MPO activity(by colorimetry),IL-6 content(by ELISA),β-arrestin-2 mRNA and protein expression(by RT-PCR and Western blot respectively).Blood samples and bronchoalveolar lavage fluid were collected to calculate pulmonary vascular permeability index(PV PI).Results Compared with group S,PVPI,IL-6 content and MPO activity were significantly increased,the expression of β-arrcstin-2 protein was significantly down-regulaled while the expression of β-arrestin-2 mRNA was up-regulated in group CLP,and PVPI,IL-6 content and MPO activity were significantly incrcased,the expression of β-arrestin-2 protein was significantly up-regulated,while the expression of β-arrestin-2 mRNA was down-regulated in group PHC(P ＜ 0.05).Compared with group CLP,PVPI,IL-6 content,and MPO activity were significantly decreased,the expression of β-arrestin-2 protein was significantly up-regulated,while the expression of β-arrestin-2 mRNA was dow n-regulated in group PHC(P ＜ 0.05).Conclusion PHC pretreatment can attenuate the lung injury induced by sepsis in mice through up-regulating the expression of β-arrestin-2 protein.

LA G1 was identified as a gene that is differentially expressed during the yeast replicative life span and was shown to play a role in determining yeast longevity. The cDNA of rat LASS1, the mammalian homolog of yeast LA G1, was cloned from rat cerebral cortex and sequenced, which is different to the predicted sequence in the GenBank. Sequence analysis revealed that this cDNA clone contains an open reading frame of 1 053 bp. The deduced amino acid sequence has 350 residues and shares a predicted Laglp motif and a TLC domain conserved in Lag1 proteins. Total RNAs were isolated from rat cerebral cortices at varying ages: newborn, one month, six months, twelve months, and twenty-four months. Semi-quantitative RT-PCR and Northern blot analysis were performed to analyze the LASS1 expression level in rat cerebral cortex tissues at varying ages. Senescence-associated β-galactosidase (SA-β-gal) activity was firstly used as a biomarker for assessing senescence in rat neurons. The results showed that LASS1 expression was upregulated from newborn to adult rats (1～6 month) and declined in aged cortex. SA-β-gal staining positive neurons significantly increased in the aged cerebral cortex. The age-related expression alternation of LASS1 in rat cerebral cortex provides an important clue in exploring the role of LASS1 in mammalian neuron aging.