Objective To investigate the clinical value of continuously detecting serum and pelvic drainage fluid C-reactive protein (CRP) and drainage fluid matrix metalloproteinase-9 (MMP-9) in the early diagnosis of anastomotic leakage after anterior resection of low rectal cancer.Methods The levels of CRP and MMP-9 in serum and pelvic drainage fluid were measured on postoperative 1,3,5,7 d in 158 patients with low rectal cancer anterior resection.The patients were divided into the anastomotic group (n=9) and non-anastomotic leakage group (n=149).The differences in the detection values between the two groups were compared and analyzed statistically.Results Among 158 cases,anastomotic leakage occurred in 9 cases.The correlation analysis of serum and drainage fluid CRP detection value and postoperative days (POD) in the two groups showed the POD 3,POD 5 and POD 7 difference was statistically significant (P＜0.05).The ROC curve analysis showed that the accuracy of the serum and drainage fluid CRP continuous detection for diagnosing the anastomotic leakage on postoperative 3 d was middle,which on postoperative 5,7 d was higher.The patients with CRP detection value ＞ 128.23 mg/L and drainage fluid CRP ＞89.93 mg/L on postoperative 5 d and those with CRP detection value＞113.71 mg/L and drainage fluid CRP＞81.75 mg/L on postoperative 7 d developed the anastomotic leakage.The drainage fluid MMP-9 detection value had no statistical difference between the anastomotic leakage group and the non-anastomotic leakage group (P＞0.05).Conclusion Continuous detection of serum and drainage fluid CRP level can be used for early diagnosing postoperative anastomotic leakage in low rectal cancer anterior resection.The drainage fluid MMP-9 continuous detection has no relation with early diagnosis of anastomotic leakage after low rectal cancer anterior resection.

Zang-fu syndrome differentiation from Huangdi Neijing, laid the theoretical foundation. Hua Tuo'S Zhongzhang Jing, Sun Simiao's Qianjin-Yaofang, Zhang Yuansu Yixue-Qiyuan and other ancient physicians enriched the Zang-fu theory.Zang-fu syndrome differentiation became systematic and widely used in clinical. This paper traced the source of the theory, explored the development of syndrome differentiation theory.

Objective To explore the anti-tumor effect and the influence of antitumor immunity of PD-L1/PD-1 blocked by PD-1 antibody combined with cisplatin. Methods Tumor models were established by injecting TC-1 cells into C57BL/6 mice, and the mice were divided into four groups (n = 4). The tumor growth curves and survival curves were drawn to observe the anti-tumor effect. The tumors were then removed; and the PD-L1 and CD8+ T cells were analyzed by immunohistochemical method. Results The anti-tumor effect was greater in the cisplatin group , PD-1 antibody group , and PD-1 antibody plus cisplatin group than in the control group (P < 0.05). Expression of PD-L1 in the tumor tissues was markedly increased in the cisplatin group and it was obviously decreased in the combination group (P < 0.05). CD8+ T cells decreased in the cisplatin group; and expression of CD8+ T cells was significantly increased the combination group (P < 0.05). Conclusion The anti-tumor effect and anti-tumor immunity of cisplatin are enhanced by blocking PD-L1/PD-1 pathway with PD-1 antibody.

Objective To evaluate the efficacy and safety of standardized seton therapy combined with the counterparts drainage improved surgical approach on the treatment of high anal fistula,and to form the technical specifications and application programs.Methods 120 patients of high anal fistula (simple and complex) from three centers were randomly divided into a treatment group and a control group,60 cases in each group.SPSS 16.0 was used to make a statistical analysis on actual enrolled patients,fall off and excluded patients.Demographics,distribution of cases and baseline data were also compared between the two groups to determine the efficacy and safety.The treatment group was treated with a modified hanging line with their counterpart drainage; while the control group was treated with traditional low cut high hanging line method.The length of healing time,hung off times,healing time,postoperative pain,anal and manometry were observed in both groups.Results Among 120 cases,118 eases were effective and 2 eases excluded off Healing time of the treatment group (29.87±3.93)d was less than the control group(35.32±8.61)d,P＜0.05.Hang off time of the treatment group (13.73±3.15)d was less than the control group (14.98±6.84) d,P＜0.05.Although the postoperative pain scores of the treatment group was lower than the control group,but with not statistical significance.Anal manometry was within the normal range,and anal function was not affected.Conclusion The quantitative hung up with the improved counterparts drainage surgical methods were safe and effective in the treatment of high anal fistula.

Objective To observe the efficacy and safety of the treatment on postoperative pain of anal disease by ear-point taping and pressuring. Methods Using random number table method,118 patients with postoperative pain of anal diseases were divided into 5 groups, namely 26 cases of analgesia group treated by main ear-point, 20 cases of group one treated by analgesia compatibility ear-point, 22 cases of group two treated by analgesia compatibility ear-point, 27 patients of group three treated by analgesia compatibility ear-point, and 23 patients of control group. The main ear-point for analgesia included TF(4) and the sensitive point matching with diseased area;Based on the main ear-point, compatibility ear-point group one add to AT(4)、CO(18)、AH(6a);compatibility ear-point group two add to CO(7)、HX(2)、HX(5);compatibility ear-point group three add to AH(6a)、AT(4)、HX(5);and the control group was treated with oral indomethacin tablets. All five groups were treated for 30 min, and the clinical analgesic efficacy and safety were evaluated. Results Pain scores decreased rates of the main ear-point analgesia group, compatibility ear-point analgesia group one, compatibility ear-point analgesia group two, compatibility ear-point analgesia group three, and the control analgesia group at 10 min after treatment was (6.49±1.98)%, (5.90±1.52)%, (6.10±2.22)%, (6.64±2.25)%, and (7.61± 1.10)%respectively. Compared with the control group , the main ear-point analgesia group or the compatibility ear-point analgesia group one or the compatibility ear-point analgesia group two, the difference was significant (P<0.05) . At 30 min after treatment, integral reduce pain rate of the above groups was (0.45±0.23)%, (0.43±0.18)%, (0.42±0.19)%, (0.38±0.25)%, and (0.38±0.23)%, the difference was not statistically significant between the control group and the other four groups (P>0.05). Conclusion The effects of 10 min treatment of ear-point taping and pressuring treating postoperative pain of anal disease was significantly better than the control group,however the 30 min treatment did not show significant difference.

This study was aimed to establish the determination method of nineorganic solvent residues of macrop-orous resin. Headspace capillary gas chromatography (GC) was used in the content determination of hexane, benzene, methyl-benzene, o-xylene, m-xylene, p-xylene, styrene, diethyl-benzene and divinyl-benzene of macroporousresin residues in Ginkgo leaf tablets. The results showed that ninemacroporous resin residues in Ginkgo leaf tablets were completely separated. The calibration curves were in good linearity (r=0.9992-0.9998). The average recoveries were 80%-110%. It was concluded that themethod was accurate, quick, and sensitive, which can be used to determine the macroporous resin residues in Ginkgo leaf tablets.

Purpose To quantitatively evaluate longitudinal strain and strain rate (SR) of left ventricular (LV) in normal infants and young children using velocity vector imaging (VVI). Materials and Methods A total of 50 normal infants and young children were enrolled in the study. The longitudinal strain peaks and SR peaks in three sections of LV walls during systole period and relaxation period were measured by VVI from apical four-chamber view, apical two-chamber view and long axis view, respectively. Results Forty-one cases (82%) presented a smooth strain curve without incisures and a double peak in SR curve (systolic peak and single diastole peak). The strain in anterior septum and posterior septum, the systolic SRs and diastolic SRs decreased from basal to apical segments. However, only the strain in basal segment and that in apical segment in anterior septum showed statistic difference (t=1.79, P<0.05);the systolic SRs of the same level in different walls and those in the same wall at different levels had no statistic difference (P>0.05). Conclusion Most normal infants and young children present a smooth diastolic strain curve and a double peak SR curve of LV, which can provide clinical guidance in the early diagnosis of myocardial abnormality for infants and young children.

Objective To investigate the mechanisms of erythropoietin-producing hepatocellular A3 (EphA3) in the invasion of hepatocellular carcinoma (HCC) cells.Methods Hepatic cell HL-7702 and HCC cell and HCC cell lines HepG2 and MHCC97H were cultured.The expression of EphA3 in the HepG2 and MHCC97H cells was suppressed by siRNA interference,and then were divided into the untreated group,the control group and the siRNA intervention group.The expression of EphA3 was detected by RT-PCR and Western blot.The invasion ability of HepG2 and MHCC97H was detected by Transwell chamber.The protein expression of VEGF and activity of vascular endothelial growth factor (VEGF) were detected by western blot and ELISA.All data were analyzed using the analysis of variance or LSD-t test.Results The relative mRNA expressions of EphA3 in HL-7702,HepG2,and MHCC97H cells were 0.94 ±0.13,1.76 ±0.16 and 3.62 ±0.14,respectively,and the protein expressions of EphA3 in the 3 cells were 0.96 ±0.12,1.59 ±0.11 and 3.82 ±0.11.There was significant difference in the EphA3 expression between HL-7702 cells and HepG2,MHCC97H cells (t =2.511,6.437 ; 2.321,6.895,P ＜ 0.05).The relative mRNA expressions of EphA3 in the HepG2 cells in the untreated group,the control group and the siRNA intervention group were 0.95 ±0.11,0.96 ±0.12 and 0.31 ±0.15,respectively.There was significant difference in the mRNA expression of EphA3 in the HepG2 cells between the siRNA intervention group and the control group (t =4.051,P ＜ 0.05).The relative mRNA expressions of EphA3 in the MHCC97H cells in the untreated group,the control group and the siRNA intervention group were 0.97 ± 0.16,0.95 ± 0.14 and 0.40 ± 0.11,respectively.There was significant difference in the mRNA expression of EphA3 in the MHCC97H cells between the siRNA interference group and the control group (t =5.237,P ＜0.05).The relative protein expressions of EphA3 in the HepG2 cells in the untreated group,the control group and the siRNA intervention group were 0.97 ± 0.16,0.95 ± 0.15 and 0.32 ± 0.17,respectively.There was significant difference in the protein expression of EphA3 in the HepG2 cells between the siRNA interference group and the control group (t =4.145,P ＜ 0.05).The relative protein expressions of EphA3 in the MHCC97H cells in the untreated group,the control group and the siRNA intervention group were 0.95 ± 0.11,0.96 ± 0.12 and 0.38 ±0.17,respectively.There was significant difference in the protein expressions of EphA3 in the MHCC97H cells between the siRNA interference group and the control group (t =4.327,P ＜ 0.05).The numbers of HepG2 cells penetrated the Watrigel in the untreated group,the control group and the siRNA intervention group were (111 ±4)/10HPF,(109 ±5)/10HPF and (51 ±3)/10HPF,respectively.There was significant difference in the number of HepG2 cells between the siRNA interference group and the control group (t =7.582,P ＜ 0.05).The numbers of MHCC97H cells penetrated the Watrigel in the untreated group,the control group and the siRNA intervention group were (402 ± 6)/10HPF,(397 ± 7)/10HPF and (152 ± 7)/10HPF,respectively.There was significant difference in the number of MHCC97H cells between the siRNA interference group and the control group (t =9.479,P ＜ 0.05).The relative protein expressions of VEGF in the HepG2 cells in the untreated group,the control group and the siRNA intervention group were 0.98 ± 0.11,0.96 ± 0.13 and 0.57 ± 0.11,respectively.There was significant difference in the protein expression of VEGF of the HepG2 cells between the siRNA interference group and the control group (t =3.167,P ＜ 0.05).The relative protein expression of VEGF in the MHCC97H cells in the untreated group,the control group and the siRNA intervention group were 0.97 ±0.14,0.98 ±0.12 and 0.34 ± 0.15,respectively.There was significant difference in the protein expression of VEGF of the MHCC97H cells between the siRNA interference group and the control group (t =4.278,P ＜ 0.05).The relative activities of VEGF proteins of HepG2 cells in the untreated group,the control group and the siRNA intervention group were 0.96 ±0.15,0.94 ±0.11 and 0.47 ±0.13,respectively.There was significant difference in the activity of VEGF protein in the HepG2 cells between the siRNA interference group and the control group (t =3.981,P ＜ 0.05).The relative activities of VEGF proteins in MHCC97H cells in the untreated group,the control group and the siRNA intervention group were 0.98 ±0.12,0.97 ±0.12 and 0.38 ±0.14,respectively.There was significant difference in the activity of VEGF protein in the MHCC97H cells between the siRNA interference group and the control group (t =4.059,P ＜ 0.05).Conclusions EphA3 plays an important role in the invasion of HCC cells via regulating the protein expression and activity of VEGF.EphA3 might be a new target for the treatment of HCC.

Background: Carbon nanoparticles show significant lymphatic tropism and can be used to identify lymph nodes surrounding mid?low rectal tumors. In this study, we analyzed the effect of trans anal injection of a carbon nanoparti?cle suspension on the outcomes of patients with mid?low rectal cancer who underwent laparoscopic resection. Methods: We collected the data of 87 patients with mid?low rectal cancer who underwent laparoscopic resection between November 2014 and March 2015 at Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College. For 35 patients in the experimental group, the carbon nanoparticle suspension was injected transan?ally into the submucosa of the rectum around the tumor 30 min before the operation; 52 patients in the control group underwent the operation directly without the injection of carbon nanoparticle suspension. We then compared the operation outcomes between the two groups. Results: In the experimental group, the rate of incomplete mesorectal excision was lower than that in the control group, but no significant difference was found (2.9% vs. 7.7%, P = 0.342). The distance between the tumor and thecircumferential resection margin was 5.8 (P = 0.001). The mean number of lymph nodes removed was 28.2 ± 9.4 in the experimental group and 22.7 ± 7.3in the control group (P and 4.5 ± 3.7, respectively (P < 0.001). Three patients in the experimental group received lateral lymph node resec?tion. Among the three patients, we retrieved three nodes (one stained node) from the first patient, three nodes (two stained nodes) from the second patient, and two nodes (no stained nodes) from the third patient. Conclusions: Injecting a carbon nanoparticle suspension improved the outcomes of patients who underwent laparoscopic resection for mid?low rectal cancer; it also improved the accuracy of pathologic staging. Moreover, for selected patients, this technique narrowed the scope of lateral lymph node dissection. ± 1.4 mm in the experimental group and 4.8 ± 1.1 mm in the control group= 0.003); the mean number of lymph nodes smaller than 5 mm in diameter was 10.1 ± 7.5 and 4.5 ± 3.7, respectively (P < 0.001). Three patients in the experimental group received lateral lymph node resection. Among the three patients, we retrieved three nodes (one stained node) from the first patient, three nodes (two stained nodes) from the second patient, and two nodes (no stained nodes) from the third patient. Conclusions: Injecting a carbon nanoparticle suspension improved the outcomes of patients who underwent laparoscopic resection for mid-low rectal cancer; it also improved the accuracy of pathologic staging. Moreover, for selected patients, this technique narrowed the scope of lateral lymph node dissection.

OBJECTIVETo investigate the influence of seasons, blood types and semen parameters on the cryosurvival rate of frozen-thawed spermatozoa from sperm donors.

METHODSWe retrospectively analyzed the influence of seasons, blood types, abstinence period, semen volume, sperm morphology, and pre-freeze sperm motility and concentration on the cryosurvival rate of frozen-thawed sperm in 4 088 semen samples from Shaanxi Human Sperm Bank.

RESULTSThe cryosurvival rate of the post-thaw sperm was correlated negatively with the progressive motility of the pre-freeze sperm (r = -0.262, P < 0.01), but positively with pre-freeze sperm concentration (r = 0.247, P < 0.01), and it was significantly higher in the 6-day abstinence group ([70.2 +/- 5.4]%) than in the other abstinence groups (P < 0.01), so was it in the normal sperm morphology rate > 20% group ([71.4 +/- 5.1]%) than in the others (P < 0.01). The survival rate of the post-thaw sperm was not correlated with seasons, blood types, and semen volume (P > 0.05).

CONCLUSIONSperm motility, concentration and morphology and the abstinence period of sperm donors may be valuable predictors of the cryosurvival rate of post-thaw sperm, but no correlation was found between the survival rate and seasons, blood types and semen volume.