Objective To study surgical techniques and clinical effects of minimally invasive excision of high rectal carcinoid tumors with anus preservation. Methods We conducted transanal local excision of rectal carcinoid tumors in 6 cases by using self-made proctoscope and laparoscopic instruments from August 2002 to January 2005. The tumors were located on the depth of 9~12 cm from the anal verge, and excision margin was 0.5~1 cm from the tumors. Results All the operations were performed successfully. A follow-up for 3~28 months (mean, 15 months) found no recurrence, metastasis, rectal stenosis, or other short- or long-term complications. The postoperative hospital stay was 3~6 days. No analgesics were required. Conclusions Transanal local excision of high rectal carcinoid tumors under proctoscope is safe, reliable, minimally invasive, and cost-effective.

0.05), but there were significant differences after the operation (P

Objective To observe the effect of traditional Chinese medicine (TCM) Qingshen granule on signal transduction pathway of fokal adhesion kinase-rat sarcoma-mitogen activated protein kinase (FAK-Ras-MAPK) in renal tissue of rats with renal interstitial fibrosis (RIF). Methods Forty Spargue-Dawley (SD) rats were randomly divided into normal control, model, Bailing capsule and Qingshen granule groups (each, n = 10). The rat model with RIF was reproduced by unilateral ureteral obstruction (UUO) or ligation method. The rats in Bailing capsule group were treated with Bailing capsule dissolved in 4 mL warm water, and the dosage was 0.3 g·kg-1·d-1 for intragastric administration;the rats in Qingshen granule group were treated with Qingshen granule dissolved in 4 mL warm water, its dosage was 6 g·kg-1·d-1 for intragastric administration, and equal volume of normal saline was given to normal control group and model group by gavage. After treatment for 8 weeks, the levels of blood urea nitrogen (BUN), serum creatinine (SCr), fibronectin (FN),α-smooth muscle actin (α-SMA) were determined in each groups. The renal tissue expression levels of FAK, Ras, p38MAPK, FN, α-SMA were determined in various groups by immunohistochemistry staining method. Results Compared with the normal control group, the levels of serum BUN, SCr, FN and α-SMA were significantly increased in the model group. There were no significant differences in the levels of serum BUN and SCr before administration of drugs between Bailing capsule group and Qingshen granule group (both P>0.05). The levels of BUN, SCr, FN, andα-SMA were all significantly lowered in the two treatment groups than those of the model group after administration, the descent in Qingshen granule group being more marked [BUN (mmol/L):13.18±4.91 vs. 18.56±5.59, SCr (μmol/L): 104.80±12.04 vs. 119.02±12.47, FN (mg/L): 29.72±16.75 vs. 46.38±8.63, α-SMA (kU/L):5.49±2.68 vs. 7.13±2.37, all P < 0.05]. The immunohistochemistry staining showed: the kidney tissue expression levels of FAK, Ras, p38MAPK, FN, and α-SMA in the model group were significantly higher than those of normal control group, above indexes were all significantly lower in Bailing capsule group and Qingshen granule group than those of the model group, and the descent in Qingshen granule group was more obvious (FAK: 3.00±1.41 vs. 5.28±2.21, FN: 4.25±1.04 vs. 6.29±2.06, α-SMA: 3.25±1.28 vs. 4.86±1.57, p38MAPK: 2.50±1.31 vs. 4.71±2.50, Ras:3.50±1.41 vs. 4.29±1.38, all P<0.05). Conclusion Qingshen granule can reduce serum BUN and SCr levels in rats with RIF, and inhibit the activation of FAK-Ras-MAPK signal transduction pathway in the kidney, thereby it may reduce the generation of FN andα-SMA and play a role of anti-RIF.

Objective To investigate the effect of inversion time (TI) on flow-sensitive alternating inversion recovery (FAIR) perfusion imaging of spinal bone marrow (SBM),and evaluate the reproducibility of blood flow (BF) measurements using this technique.Methods Twenty four healthy volunteers without lumbar and other disease with clinical and MR studies were prospectively included.The first 14 healthy volunteers were included to study the effect of TI on ASL perfusion imaging of SBM to get the optimized TI,the remaining 10 volunteers were included to investigate the reproducibility of the SBM arterial spin labeling (ASL) scan protocol.The optimized TI of FAIR spinal bone marrow perfusion experiment was carried out on 14 healthy volunteers on 3.0 T magnet,two adjacent vertebral bodies were orderly selected from each volunteer to measure the △M and the SNR of FAIR perfusion MRI with 5 different TIs (800,1 000,1 200,1 400,1 600 ms),and the vertebral bodies selected order were determined by the order of the subjects enrolled.In addition,FAIR perfusion spinal vertebral BF measurements were repeated in last l0 healthy subjects on L4 or L5 by reposition immediately,paired t test and reproducibility statistics (included within-patient standard deviation (wSD) and within-patient coefficient of variation (WCV)) were used to analyze the test-retest experiment reproducibility.Result TI optimization experiments total included 28 vertebral bodies,when TI (ms) was chose as 800,1 000,1 200,1 400,1 600,ms respectively,the mean △M of spinal bone marrow were 20.8±9.0,29.0± 10.9,36.4± 12.5,26.2± 10.2 and 23.8± 11.5,and the mean SNR were 2.0± 1.0,2.3±0.8,2.4± 1.0,2.3±0.8 and 2.0±0.7.With TI increasing,AM and SNR increased first and then decrcascd,the maximum values of both were achieved when the TI near 1 200 ms.Test-retestexperimcnt were carried on 10 vertebral bodies eventually,and two measurements of spinal vertebral BF perfusion before and after were (108.9±4.6)and (109.2 ±4.6)ml · 100g-1· min 1,respectively,and no significant difference was found (t=-0.157,P=0.879),wCV of the measurements was 3.28％ (3.57/109.06).Conclusion The optimal TI was 1 200 ms for spinal bone marrow ASL perfusion image,at which the maximum AM,higher SNR,and good reproducibility for the FAIR spinal bone marrow perfusion imaging can be achieved.

OBJECTIVE: To summarize advances in clinical application of ureter stent and its biocompatibility. METHODS: A computer-based online search of CNKI (1989/2009) and Medline (1989/2009) was performed with the key words of "ureter, biocompatibility, stent, treatment, complications" in Chinese and English respectively. A total of 51 articles were collected. and 21 were included. The treatment advances and its biocompatibility of ureter stent were summarized, and clinical application advances, biocompatibility and complication prevention of ureter stent were explored. RESULTS: Ureter stent includes polymerizer, metal and degradable material stents. As the common implants in treatment of upper urinary tract diseases, ureter stent functions as stent and internal drainage, and relieve ureteral obstruction, prevent leakage of urine postoperatively and ureterostenosis. Complications following ureter stent implantation include stent shifting, urine reflux, irdtative symptoms of bladder, fouling and stone formation as well as infection. However, these complications can be relieved through positive treatment. CONCLUSION: Ureter stent is an effective approach to treat urologic disease, but the biocompatibility required improvement. Rigorous operation during stent implantation and positive treatment of complication can effectively prevent complications.

Objective To observe the improvement effects of Qingshen Granule on the life quality of chronic kidney disease (CKD) patients with damp-heat syndrome. Methods The CKD patients with damp-heat syndrome were randomly divided into experimental group and control group. The control group was treated with Western medicine, and the treatment group was treated with Qingshen Granules additionally for 12 weeks. SCr and eGFR were observed before and after treatment, and the life quality was investigated by KDQOL-SFTM1.3. Results Actually 156 cases were completed, including 77 cases in the treatment group and 79 cases in the control group. The total rate of curative effect was 81.82% (63/77) in teatment group, and (63.29%, 50/79) in control group, with significent difference (P<0.05). Multivariate linear regression analysis indicated that gender, education level, TCM syndrome score, CKD stage, eGFR and Hb level could affect the life quality. The scores of KDQOL-SFTM and its containing the MOS item short from health survey (SF-36) and kidney disease targeted areas (KDTA) were significantly improved after treatment in experimental group (P<0.05), while the scores in control group were with no significant improvement. The improving effects of PCS, and SPL, SLEEP, PS in KDTA in treatment group were significantly superior to those in control group (P<0.05). The scores of life quality in effective and stable cases increased significantly after treatment compared with before treatment (P<0.05). Conclusion Qingshen Granules can effectively improve the life quality of CKD patients with damp-heat syndrome, and the effect is not dependent on the improvement of laboratory indexes (renal function).

Objective:To investigate the protective effect of ergosterol on neurons in CA1 area of the hippocampus and its mechanism in rats anesthetized with propofol.Methods:Forty-five SD rats were randomly divided into control group, propofol group and propofol+ergosterol group ( n=15). Rats in the control group were injected intraperitoneally with 100 mg/kg fat emulsion solvent; rats in the propofol group were injected intraperitoneally with 50 mg/kg propofol first, and after the righting reflex was restored, they were injected with 50 mg/kg propofol; propofol+ergosterol group was intraperitoneally injected with 30 mg/kg ergosterol, followed by propofol injection, and the propofol injection method was the same as that of the propofol group. Injection was given continuously for 7 d. After the last injection, the rats in each group were awake for 2 h. The ultrastructure of neurons in hippocampal CA1 area was observed by transmission electron microscopy. HE staining, TUNEL and neuronal nuclear antigen (NeuN) staining, and Western blotting were used to detect the morphology, apoptosis, and postsynaptic density protein 95 (PSD95) expression of neurons in the hippocampal CA1 area, respectively. Western blotting was used to determine the expressions of apoptosis-related proteins and phosphatidylinositol 3-kinase (PI3K)-protein kinase B (Akt) signaling pathway proteins in hippocampal CA1 area of rats. Results:Transmission electron microscopy and HE staining showed that the damage of neurons in the hippocampal CA1 area of the propofol+ergosterol group was slighter than that of the propofol group. As compared with control group, propofol group had significantly higher neuronal apoptosis, significantly higher levels of activated Caspase 3 and Bax protein expressions, significantly decreased Bcl-2 and PSD95 expressions, significantly increased apoptosis inducing factor (AIF) and Cytochrome (Cyt)-C protein expressions, statistically lower Sirt1 protein expression, and significantly lower phosphorylated (p)-PI3K/PI3K level and p-Akt/Akt ratio in the hippocampal CA1 area ( P<0.05). As compared with propofol group, propofol+ergosterol group had significantly lower neuronal apoptosis in the hippocampal CA1 area (27.33±1.37% vs. 17.47±0.87%, P<0.05). As compared with propofol group, propofol+ergosterol group had significantly lower activated Caspase 3 and Bax protein expressions, significantly increased Bcl-2 and PSD95 expressions, significantly decreased AIF and Cyt-C protein expressions, statistically higher Sirt1 protein expression, and significantly higher p-PI3K/PI3K level and p-Akt/Akt ratio in the hippocampal CA1 area ( P<0.05). Conclusion:Ergosterol pretreatment can inhibit propofol-induced neuron apoptosis and alleviate the neuronal damage in the hippocampal CA1 area, whose mechanism may be mediated by PI3K-Akt signaling pathway.

Objective To investigate the effect of intrathecal injection of morphine on patients with severe rectum cancer pain.Methods According to random number table method,28 patients with severe rectum cancer pain,admitted to our hospital from April 2014 to April 2015,were divided into two groups:intrathecal injection of morphine group (group Ⅰ) and epidural injection of morphine group (group E,n=14).Patients in group Ⅰ were treated with intrathecal injection of morphine,and group E with epidural injection of morphine;initial dose of group Ⅰ was 1/300 of daily average dosage,and group E 1/30 of daily average dosage;the additional dose of two groups was 1/10 of initial dose,with a locked time of 30 min.Resting and moving visual analogue scale (VAS) scores,life scores of quality of life questionnaire (QLQ)-C30,and daily dose of morphine were observed on the day before analgesia (T0),first week after analgesia (T1),second week after analgesia (T2),and first month after analgesia (T3).Nausea and vomiting,skin itching,retention of urine,and headache were recorded at the four points.Results As compared with those at T0,the resting and moving VAS scores and daily dose of morphine were significantly lower,life scores of QLQ-C30 at the T1,T2 and T3 were significantly higher in both two groups (P＜0.05).As compared with those in group Ⅰ,the resting and moving VAS scores and daily dose of morphine in group E were significantly higher,life scores of QLQ-C30 in group E were significantly lower at the T1,T2 and T3 (P＜0.05).The incidence of complications in group Ⅰ (21.4％)was significantly lower than that in group E (71.4％).Conclusion The effect of analgesia with intrathecal injection of morphine is better than that of analgesia of epidural injection of morphine in the treatment of severe rectum cancer pain.

To adapt to the general educational requirements for military academies to prepare for victory under the new situation, the present paper proposed the overall thought of strengthening the post education for military hygiene through analyzing the main problems and causes existing in the current education, combined with the experience and practice of foreign military post education. Moreover, we combined the current situation and reality of post education in military medical universities, and analyzed the corresponding countermeasures from the aspects of teaching staff, course construction, information construction, teaching method and assessment model, expecting to provide guidance and help for better carrying out the post education of military hygiene in the future.

OBJECTIVE: To evaluate the therapeutic effect of Qingshen Granules on renal anemia in patients with damp-heat syndrome and explore the mechanisms in light of inflammation/hepcidin axis and iron metabolism. METHODS: Sixty patients with renal anemia and dampness-heat syndrome were randomized into control group (=30) and treatment group (=30). All the patients were given routine treatment, and the patients in the treatment group received additional treatment with Qingshen Granules (3 times a day). After 12 weeks of treatments, the patients were examined for changes in the integral value of TCM syndrome, serum creatinine (Scr), glomerular filtration rate (eGFR), hemoglobin (HGB), hematocrit (HCT), red blood cell (RBC) count, interleukin-6 (IL-6), hypersensitive C-reactive protein (hs-CRP), ferritin, growth differentiation factor-15 (GDF-15), serum iron (SI), total iron binding capacity (TIBC), transferrin saturation (TAST), soluble transferrin receptor (sTfR) and ferritin levels. RESULTS: After the treatment, the scores of TCM syndrome were significantly improved in the treatment group and were better than those in the control group (=0.000). Scr and eGFR were improved in both groups after the treatment. The levels of HGB, HCT and RBC were all improved in the two groups after treatment, and the improvements were more obvious in the treatment group (=0.002, 0.002, and 0.017, respectively). The levels of IL-6, hs-CRP, hepcidine and GDF-15 were all lowered in the two groups after the treatment, and they were all significantly lower in the treatment group than in the control group (all =0.000). The treatments increased the levels of SI and TAST in both of the groups, and compared with those in control group, the levels of TIBC, sTfR and ferritin were significantly lowered in the treatment group after the 12-week treatment (=0.000). CONCLUSIONS Qingshen granules can effectively improve renal anemia in patients with damp-heat syndrome possibly by improving iron metabolism through alleviation of inflammation and reduction of hepcidine level.