Objective To investigate the efficacy and safety of nickel titanium compression anastomosis clip (CAC) in gastrointestinal anastomosis.Methods The clinical data of 413 patients who received gastrointestinal anastomosis with nickel titanium CAC or curved stapler at the First Affiliated Hospital of Fujian Medical University from January 2007 to December 2011 were retrospectively analyzed.All the patients were divided into the CAC group (227 patients) and the curved stapler group (186 patients).The time for gastrointestinal anastomosis,anastomotic bleeding,complications,condition of the incision sites,the first postoperative flatus and time for the excretion of the CAC between the 2 groups were compared.All data were analyzed using the t test or chisquare test.Results The time for gastrointestinal anastomosis of the CAC group was (8.3 ± 2.5) minutes,which was significantly shorter than (18.7 ± 3.6) minutes of the curved stapler group (t =5.74,P ＜ 0.05).There were no significant difference in the time of postoperative flatus,duration of hospital stay and costs between the 2 groups (t =0.27,1.32,3.11,P ＞ 0.05).No patients in the CAC group had anastomotic bleeding,while the incidence of anastomotic bleeding of the curved stapler group was 3.23 ％ (6/186),with a significant difference between the 2 groups (x2=7.43,P ＜ 0.05).The incidences of gastric emptying dysfunction of the CAC group and the curved stapler group were 0.88％ (2/227) and 1.08％ (2/186),with no significant difference between the 2 groups (x2=0.04,P ＞ 0.05).The incidences of postoperative anastomotic stricture and anastomositis were 0 (0/227) and 11.01％ (25/227) in the CAC group,and 2.15％ (4/186) and 21.50％ (40/186) in the curved stapler group,with significant differences between the 2 groups (x2 =4.93,8.49,P ＜ 0.05).No anastomotic fistula was detected in the 2 groups.The CAC was excreted at postoperative day 12-26.Conclusion CAC is safe and effective for gastrointestinal anastomosis.

Objective:To measure the expression of signal-induced proliferation-associated gene 1 (Sipa1) in gastric cancer and to determine its association with the clinicopathological characteristics and prognosis of patients with gastric carcinoma. Methods:The Sipa1 mRNA and Sipa1 protein expression levels in 43 fresh gastric carcinoma tissues and adjacent normal tissues were measured by real-time PCR and Western blot analysis. The Sipa1 protein expression levels in 122 paraffin blocks of gastric cancer and 64 normal gastric tissues were determined by substance P immunohistochemical technique. Results:The Sipa1 mRNA and Sipa1 protein levels in fresh gastric carcinoma tissues were significantly lower than those in adjacent normal tissues. Sipa1 protein was positive in 36.1%of the paraffin blocks of gastric cancer and in 73.4%of normal gastric tissues. The difference was statistically significant (P<0.05). Sipa1 protein expression was significantly correlated with tumor differentiation, lymphatic metastasis, invasive depth, and clinical stage (P<0.05) but not with age, gender, tumor size, and tumor areas (P>0.05). The five-year survival rates of Sipa1-negative patients were significantly lower than those of Si pa1-positive patients (P<0.01). Conclusion:Sipa1 expression is highly correlated with the biological behavior of gastric carcinoma and thus facilitates the evaluation of gastric carcinoma prognosis.

Objective To investigate the expression and significance of UbcH10 in gastric cancer.Methods The expression of UbcH10 in 117 cases of gastric carcinoma tissues,who were followed up postoperatively,were detected by using immunohistochemistry; The expression among different histological grades and clinical stages are analyzed by statistics; Real-time polymerase chain reaction (Rt PCR) and Western blot method were used to detect the expressions of UbcH10 mRNA and protein in 43 cases of gastric carcinoma tissues and the cancer adjacent normal tissues.Results In paraffin fixed blocks of gastric cancer,positive rate of UbcH10 protein expression was higher than normal gastric tissues (83％ vs 55％,Rs =-0.397,P＜0.01).The difference of UbcH10 expression was not significant in gender,age,tumor site and size of the tumor(Rs =0.369,-0.378,-0.276,0.421,P ＜ 0.05),while it was significantly correlated to tumor differentiation,invasive depth,lymphatic metastasis and clinical stage (Rs =0.369,-0.378,-0.276,0.421,P ＜0.05).UbcH10 and Ki-67 protein and HER-2 expression were in significantly positive correlation (Rs =0.834,Rs =0.281,P ＜ 0.01).UbcH10 mRNA and protein expression in fresh gastric carcinoma tissues was higher than that in their corresponding adjacent normal tissues(ACt =32.2±5.19,4.69 ±1.26,t =26.8,P＜0.01),(0.74±0.45,0.11 ±0.04,t =8.09,P＜0.01).The -5 year patient's survival rate in UbcH10 highly-expressed gastric cancer was higher compared to those with UbcH10 low-expression(x2 =13.116,P ＜0.01).Conclusions UbcH10 is upregulated in gastric cancer,and expression of UbcH10 is closely related to the prognosis of patients with gastric cancer.

Objective To evaluate the clinica1 value of endoscopic placement of colorectal metal stents for malignant colonic obstruction in aged patients. Methods The 82 cases who were older than 65 years with malignant colonic obstruction were randomly divided into colorectal metal stenting group who were treated with endoscopic Niti-S colorectal metal stenting and emergency surgery group who were treated with tumor resection or colostomy. The average length of stay, average hospitalization charge, median survival time, one-year survival rate, perioperative mortality, and the complications such as anastomotic leakage, incision infection were analyzed. Results In colorectal metal stenting group, in 39 of 41 patients, metal stents were successfully inserted, without complications of hemorrhage, perforation and so on. And the symptoms of obstruction were effectively relieved within 2 days. The 17 cases underwent subsequent elective radical resection of colorectal carcinoma after 1 week, without complications of anastomotic leakage. The 22 cases were treated with colorectal metal stenting for palliative treatment. There were 4 cases of stent migration and 5 cases of stent obstruction again. The average length of inhospital stay was (17.9±6.7) days, the average hospitalization charge was 40 047 yuan, the median survival time was (9.4±4.4) months, and one-year survival rate was 43.9%. In emergency surgery group, 13 cases underwent tumor resection and 28 cases received colostomy. The 14 cases presented with multiple organ dysfunction, 8 cases died preoperatively, 4 cases presented with anastigmatic leakage. The average length of stay was (24.4±4.6) day, the average hospitalization charge was 61 867 yuan, the median survival time was (8.8±4.8) months, and one-year survival rate was 36.6%. Conclusions Endoscopic colorectal metal stenting is a safe, economic and effective treatment for malignant colonic obstruction in aged patients, especially reduces the risk of surgical complications, improves the aged patient's quality of life.

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.

With the continuous improvement and innovation of modern engineering technology and biomedical technology,many efforts and process have been made on multifunctional prosthesis systems and have gained more and more attentions.The multifunctional powered prosthesis has become one of the research areas in the current muscular rehabilitation medicine and neural engineering.The bionic control of prosthesis,especially using the neural signal to control the upper prosthesis effectively,is one of the most important fields of prosthesis technology.Choosing the proper neural signals seems to be particularly important for bionic prosthetic control strategy.Currently,several different signal controls such as EMG control,EEG control,voice signal control and peripheral nerve signal control have been proposed and investigated for the bionic control of multi-function prosthesis.This paper reviews the latest efforts and progress of multifunctional upper prosthesis.

OBJECTIVE To discuss the liable episodes of the urinary tract infection with relation of catheter and propose the prevention measures.METHODS We radomly selected 536 patients with catheter.The urinary tract infection,as well as related factors were observed in patients with indwelling catheter.RESULTS The catheter replacement time interval as well as indwelling time were the risk factors,when the indwelling catheter time was 1-3 days,the CAUTI rate was 10.3%,if the time was ≥10 day,the CAUTI rate was 97.6%.Additionally the antibiotic use would cause dysbacteriosis which also easily caused the urinary tract road infection.CONCLUSIONS When taking care of the patients who had catheter,we should grasp the indications of catheterization,reduce the indwelling time,apply the effective nursing measures and correct choice of antibiotics,that can evidently control the infection.

Background and purpose:This study aimed to estimate the spike-effect of domestic nanometer activated carbon on the radical operation for early stage low-lying rectal cancer. Methods:From Jan. 2013 to Dec. 2015, 66 patients with early stage low-lying rectal cancer were randomly divided into two groups:study group and control group. The patients of study group were treated with injection of carbon nanoparticles suspension in tumor vicinity before the operation. This study compared the total number of lymph node, the scale percentage of micro lymph node between two groups. SLNs of study group were obtained for pathological examination. Results:The differences in the total number of lymph node and the scale percentage of micro lymph node between two groups were statistically signiifcant (P<0.05). The diagnostic sensitivity and false-negative rate were 90.9%and 3.8%, respectively. Conclusion:Local injection of nanometer activated carbon around the tumor is important to the metastasis lymph node resection, especially to SLN biopsy in the radical operation for rectal cancer.

Objective To investigate the impact of splenectomy on the prognosis and immune function of patients with end stage carcinoma of the esophagogastric.Methods The clinical data of 61 patients with end stage carcinoma of the esophagogastric junction who were admitted to the First Affiliated Hospital of Fujian Medical University from January 2007 to December 2010 were retrospectively analyzed.All the patients were divided into splenectomy group (22 patients) and spleen preservation group (39 patients).The immune function before operation,on the 10th day and the 6th month after operation was detected.The intra-and postoperative conditions of the patients of the 2 groups were compared.All data were analyzed using the independent sample t test or chisquare test.Results The levels of IgA,IgG,IgM,CD3 and CD4 in the splenectomy group at the 10th day after operation were significantly higher than those before operation (t =2.55,3.33,3.40,2.92,2.10,P ＜ 0.05).The levels of IgA,IgG,IgM,CD3,CD4,the ratio of CD4/CD8 of the spleen preservation group at the 10th day after operation were significantly higher than those before operation (t =3.35,5.29,3.33,2.60,3.53,3.12,P ＜0.05).The levels of IgA,IgG,IgM,CD3,CD4 and the ratio of CD4/CD8 in the splenectomy group at postoperative month 6 were significantly lower than those at postoperative day 10 (t ＝2.75,4.40,3.06,2.51,2.24,2.29,P ＜ 0.05).The levels of IgA,IgG,IgM,CD4,CD8 and the ratio of CD4/CD8 of the spleen preservation group were significantly higher than those of the splenectomy group,while the level of CD8 in the spleen preservation group was significantly lower than that in the splenectomy group (t =1.70,2.10,2.70,2.16,2.13,2.83,P ＜ 0.05).The operation time of the splenectomy group was (152 ± 26) minutes,which was significantly longer than (130 ± 24) minutes of the spleen preservation group (t ＝ 3.42,P ＜ 0.05).There were no significant differences in the operative blood loss,incidence of postoperative infection,median survival time,1-year survival rate between the 2 groups (t =1.38,x2 =0.78,1.22,2.51,P ＞ 0.05).Conclusion Palliative gastrectomy could reverse the immune function of spleen by decreasing tumor burden for patients with end stage carcinoma of the esophagogastric junction who can not be treated by radical resection.Spleen preservation may have positive significance for the immune function and prognosis of patients with end stage carcinoma of the esophagogastric junction.

Objective To detect CD_(36) expressions in polycystic ovary (PCO), and to explore its correlation with local androgen and insulin at transcription level. Methods From August 2002 to February 2003, 12 patients with asymmetric PCO, 15 primary or secondary infertile patients without endocrine disorders and 8 polycystic ovary syndrome (PCOS) with bilateral PCO were recruited. Extraction of follicular fluid and detection of testosterone(T), dehydroepiandrosterone sulfate (DHEAS), insulin (INS) and androstenedione (A_2) were performed. Relative CD_(36) mRNA expression level of human ovarian inner thecal cells was analyzed by auto image analysis system (IAS) after RT-PCR. Results The level of CD_(36) mRNA expression in thecal cells was 0.24?0.07 in polycystic ovary of PCO group and 0.21?0.05 in bilateral ovaries of PCOS group, respectively, which were significantly lower than 0.83?0.13 in normal ovaries (P