Objective To investigate the feasibility and safety of colorectal anastomosis using nickel titanium compression anastomosis ring (CAR).MethodsThe clinical data of 83 patients who received colorectal anastomosis at the First Affiliated Hospital of Fujian Medical University from May to December,2010 were prospectively analyzed.All patients were divided into CAR group (41 patients) and stapler group (42 patients) according to the random number table.The operation time,time to postoperative flatus and bowel movement,duration of hospital stay and the incidence of anastomosis-related complications of the 2 groups were observed.The time of extrusion of the rings and anastomotic healing of the CAR group were recorded.All data were analyzed by the t test or chi-square test.ResultsThe mean operation time of the CAR group and the stapler group were ( 122 ± 25) minutes and (128 ±30)minutes,respectively.The incidences of postoperative anastomotic fistula of the CAR group and the stapler group were 5％ (2/41) and 7％ (3/42),and the anastomotic fistula was cured by operation or conservative treatment.There were no significant differences in the mean operation time,time to postoperative flatus and bowel movement,duration of hospital stay and incidence of anastomotic fistula between the 2 groups (t =1.299,0.756,1.636,0.974,x2 =0.165,P ＞ 0.05 ).The rings were expelled within 9-14 days.The incidences of anastomotic stenosis of the CAR group and stapler group were 0 (0/41) and 2％ (1/42),with no significant difference between the 2 groups (x2 =0.988,P ＞ 0.05).The anastomotic stoma was smooth and well bealed in the CAR group,while nail residues and inflammatory polyp (1 patient) were found at the anastomosis stoma in the stapler group.ConclusionNickel titanium CAR is safe and effective in colorectal anastomosis.

Objective To evaluate the clinical application and effect of plastic surgery in emergency treatment of facial soft tissue injuries,and to explore the better plastic surgery method for facial soft tissue injuries in order to regain the patient facial morphology and function maximally.Methods The clinical data of 798 patients with facial soft tissue injuries from June 2009 to June 2011 were analyzed retrospectively.And plastic surgical techniques were applied to the early treatment of facial soft tissue injuries in this group cases,according to the size of defect and the degree of deformity of the patient,different plastic surgery treatment was chosen,such as skin flap or skin graft to repair wound surfaces.In this process,one must follow sterile noninvasive principle strictly with emphasis on the technique of plastic surgery such as entire debridement,wound healing application of skin flap and so on.Results 790 cases of facial soft tissue injuries were healed by first intention without significant complications,while 8 cases of them had mild scars.During 6 to 12 months of follow-up,neither scar,nor infections and necrosis of the wound region occurred,and the morphology and function of patients' face recovered well without the second operation.Conclusions Using plastic surgery techniques in the emergency treatment of facial soft tissue injuries as soon as possible can avoid the disfigurement and the function disturbance,and promote the facial morphology and function regeneration rapidly and effectively.

Objective To investigate the possible mechanism of the biologic ethology effects of NGF and SP(substance P)on primary cultured adrenaline medullary chromaffin cells(AMCC).Methods To establish primary cultured AMCC by means of enzyme digestion and purify the cells by means of isopycnic gradient centrifugation and differential plating.To observe the morphological and ultrastructural changes after the addition of NGF and SP,and detect the concentration of adrenaline and noradrenaline in serum by ELISA.Results Confervaceous processes could be observed after 2 d of addition of NGF to the culture and the processes strenched longer as days went by the observation of electron microscopy.there are some drumstick-like and villiform processes in the cell membrane and some vesiculation be observed near the cell membrane of the primary cultured AMCC cells after the addition of NGF.The bioblast was abundant but the structure was not clear in the intracytoplasm and the concentration of adrenaline were decreased(P

Objective To observe the extracellular content of dopamine (DA)and expression of D1 receptors in hippocampal dentage gyrus (DG)in the model rats with vascular dementia (VD),and to investigate the relationship between them.Methods 12 male SD rats were randomly divided VD group and sham-operation group,and the VD model was prepared by permanent bilateral carotid occlusion.The extracellular content of DA in the DG was determined by in vivo microdialysis and HPLC,and the expression of D1 receptors was measured by immunehisto-chemistry.Results The DA content in the DG of the rats in VD group was lower than that in sham-operation group (P <0.05).The number of D1 receptor-positive cells in the DG hilus in VD group was increased compared with sham-operation group (P < 0.05),whereas the expression of D1 receptor in DG granule cell layer did not change (P > 0.05).Conclusion The DA content in the hippocampal DG is decreased in the VD rats,and its function may be compensated by the up-regulation of D1 receptors in the DG hilus.

ObjectiveTo discuss the interaction of pregnancy and myasthenia gravis(MG) and the management of pregnancy with MG.MethodsSeven cases of pregnancy with MG in Peking Union Medical College Hospital were analyzed retrospectively,with respect to the therapy of MG,pregnancy complications and outcomes.Results Totally 38 683 pregnant women were admitted to Peking Union Medical College Hospital between Oct.1983 and Oct.2010.Among them there were 9 patients suffered from MG,with the incidence of 0.023％.Two pregnancies were terminated because of personal reasons,and seven continued.( 1 ) Onset of MG:in the 7 cases,6 were diagnosed before conception,with the mean course of 5.9 years.The other one occurred in the third trimester.(2) Management:all the cases were under close surveillance during pregnancy.Four women took thymectomy before conception,and one of them kept taking medication after surgery. In those who received thymectomy,3 cases remained stable and 1 case worsened during prenancy.The latter one took medication at 33 weeks,and continued to full term.MG exacerbated in the other three women who had not undergone thymectomy before conception.Among them, one woman complicated with systemic lupus erythematosus and lupus nephritis delivered the baby at 31 weeks.(3) Delivery and neonatal outcomes:cesarean deliveries were performed in 5 cases and the other two underwent vaginal deliveries.All the newborns were admitted to neonatal intensive care unit for surveillance.There were three smaller than gestational week (SGA) infants.No MG was observed in newborns.ConclusionsPatients with MG should have an overall evaluation before conception.The course of MG during pregnancy is unpredictable.They may get a promising outcome under the control of a multidisciplinary team including obstetricians and neurologists.Newborns should be carefully monitored for sings of transitory MG in the department of pediatrics.

Objective To analyze the endoscopic and pathological characteristics of rectum neuroendocrine neoplasm (NEN).Methods From January 2005 to May 2012,the endoscopic and pathological data of 66 patients with rectum NEN were collected and graded according to historistic grade of gastroenteropancreatic-neuroendocrine neoplasm (GEP-NEN) by World Health Organization (WHO).The factors related with the metastasis of neuroendocrine tumor (NET) and neuroendocrine cancer (NEC) were analyzed by Chi square test and Fisher exact probability method.Results The locations of 66 NEN cases were between three and 15 cm from the anus.The diameters of 54 cases were less than 1 cm and under endoscopy the appearance of most tumors was submucosal hemispherical polypoid bulge.The diameters of nine cases were over 1 cm but less than 2 cm,of which the appearance of five cases was submucosal thickening or sessile polypoid bulge.The diameter of three cases was over 2 cm and the appearance was cauliflower-like or polypoid tumor which caused annular lumen stenosis.Sixty-one cases were NET (grade G1),three cases were NEC (grade G3) and two cases were mixed adenoendocrine carcinoma with both NEC and adenocarcinoma components.The metastasis of NET and NEC was not related with gender (x2 =0.158,P＞0.05) and age (Fisher exact probability method,P＞ 0.05),however was related with the diameter of tumor (Fisher exact probability method,P＜0.05).Conclusions NEN is a tumor with variety endoscopic characteristics and pathological features.The metastasis of NET and NEC seems not related with gender and age,but related with diameter.

Objective To explore the change in nutritional status of perioperative gastrointestinal cancer patients. Methods The nutritional status of 207 gastrointestinal cancer patients who were to undergo elective radical surgery was evaluated by SGA within 48h of admission and 7 days after operation. The investigation results went through analysis. Results Body weight was significantly decreased 7 days after operation compared with 48h of admission, the prevalence of malnutrition 7 days after operation was higher than 48h of admission; weight loss, change of food intake and decreased functional activity were the related factors of change in nutritional status of perioperative gastrointestinal cancer patients. Conclusions There was a decreased nutritional status among perioperative gastrointestinal cancer patients, and appropriate nutrition intervention program and treatment should be taken to improve clinical outcomes according to the risk factors.

Humans ; MicroRNAs ; Non-alcoholic Fatty Liver Disease

Objective To explore the repair effect of the superficial iliac island flap for the hypertrophic scar of mons pubis after burned.Methods From July 2013 to July 2016,the author had treated 26 patients with mons pubis hypertrophic scar after burned.There were 19 males and 7 females among them.The age was from 1 year and 5 months to 10 years old.The scar area was of 6 cm ×5 cm-15 cm ×8 cm.Some of the patients had external genital malformations caused by scar contracture.Surgery removed the scar and completely released the basic shape of the vulva.It had to expand the superficial iliac island flap of 1 cm according to the size of the wound,and sufficient length of vascular pedicle according to the distance from the wound to the flap.The flap was cut in the superficial of the deep fascia,and reserved about 2cm wide fat along the superficial iliac artery.The superficial vein was located in the fat.The wound was covered by the flap,which was rotated directly or through a subcutaneous tunnel.Results Twenty six patients were treated with a single operation and no vascular crisis occurred.All the flaps survived.One patient delayed incision healing due to the high incision tension,and the remaining patients were in primary healing.The postoperative follow-up found that all the flaps had thin thickness,similar color to the surrounding skin,soft texture and feeling.Conclusions There are obvious signs of scarring in the mons pubis area after deep burns,and scar contracture can cause vulvar deformity.The superficial iliac island flap,which has a thin thickness,soft texture,similar color,and can be sutured directly for the donor site,is a good choice to repair the mons pubis hypertrophic scar.

Background and purpose:DOC-2 serves as one of the tumor suppressing genes in human ovarian cancer and plays a role in the process of cell growth and differentiation.This study was to investigate the role of DOC-2 in the TGF? signal pathway and verification of the interaction between DOC-2 and TGF?Ⅲ receptor.Methods:The bait vector was constructed by inserting the PID domain of DOC-2(nDOC-2)into yeast express vector pGBKT7.pGBKT7-nDOC2 was transformed into the yeast AH109 and confirmed to be expressed.After the human foetus brain cDNA library had been transformed,the positive clones was screened by both nutrition defect medium and X-?-gal.The putative positive clones were sequenced and analyzed to get the DOC-2 interactive proteins.Furthermore,after the DOC-2 cDNA and TGF?Ⅲ receptor cDNA had been co-transfected into the human ovarian cancer cell line HO-8910 together,the interaction between DOC-2 and TGF?Ⅲ receptor was investigated by immunoprecipitation and Western blot.Results:21 putative positive clones were picked after being screened and sequenced.Three of them were identified as Homo sapiens partial mRNA for betaglycan(TBR Ⅲ gene),homo sapiens protocadherin gamma subfamily C3(PCDHGC3)and APLP1(amyloid beta precursor-like protein 1).The analysis by immunoprecipitation and Western blot showed that the interaction between DOC-2 and TGF?Ⅲ receptor could form protein complex.Conclusions:The three encoding proteins might participate in the DOC-2 signal pathway.DOC-2 might play as an essential role in the TGF?signal pathway by interacting with TGF?Ⅲ receptor.