Urinary and sexual dysfunction is common complication after surgical treatment for rectal cancer patients,and many studies were carried out for these complications.This article reviewed the literatures on clinical research of urogenital function after operations of rectal cancer.

Objective To investigate the clinical effects of two minimally invasive surgical treatments for billary acute pancretitis.Method In this study,63 patients with billary acute pancretitis were prospectively divided into two groups.Patients in group A received laparoscopic cholecystectomy (LC) and laparoscopic transcyctic common bile duct exploration (LTCBDE) within 72 hours of onset,group B underwent endoscopic nasobiliary drainage (ENBD).The two groups were evaluated by blood amylase and urine amylase,alanine aminotransferase,aspartate aminotransferase on postoperative day 1,3,5,local complication and the recurrence rate within 6 months.Result Blood amylase was lower in group A than that in group B (P =0.04) on postoperative day 1.There were no significant differences in amylase,aminotransferase of two groups on postoperative day 3,5 (all P ＞ 0.05).The incidences of local complications and pancreatic necrosis infection were 2.7％,7.7％ respectively(P =0.13) ; the incidences of pancreatic pseudocyst were 5.4％,7.7％ (P =0.42) ; the recurrence rate within 6 months were 2.7％ and 19.2％ respectively(P =0.006).Conclusions The clinical curative effects of early LC and LTCBDE or ENBD on billary acute pancretitis showed no significant differences,but the recurrence rate of acute pancretitis within 6 months revealed that early LC and LTCBDE may be more effective.

Lymph node metastasis is a main route of metastasis for rectal cancer,and skip metastasis is an im portant characteristic.Many cases were found metastasis or micrometastasis in lateral or upper lymph node before the definite metastasis in mesenterium lymph node.To exactly check and diagnose the lymphnode metastasis can help manage CLIN,and influence the prognosis.In reeent years,progress has achieved in the study of lymphnode micrometestasis,and it is really a promotion for the management of rectal cancer.

Objective To study the clinicopathologic characteristics and the prognostic factors of gastric stump cancer (GSC). Methods A total of forty-seven patients with GSC from Jan 2000 to Dec 2006 were enrolled in this study for retrospective analysis. Initial surgery was performed for gastric benign disease in 39 patients and for malignant disease in 8 patients, which were divided into 2 groups for analysis. The prognosis of all 47 patients were analyzed. Results The mean interval between previous gastrectomy and diagnosis of GSC was 24.4 years. Tumor developed mostly in the patients with Billroth- Ⅱ reconstruction, and male more than female. Tumor located at anastomotic site mostly, at stump stomach and cardia secondly. The mean interval for patients who had undergone their first gastrectomy for malignant disease was shorter than that with benign disease(P＜0.05). Histology, therapy and prognosis showed no significant differences between two groups (P＞0.05). Disease TNM stage and total radical gastrectomy were shown to be significant predictor for the outcome of patients with GSC (P ＜0.01). Conclusion Now the GSC patients with initial surgery performed for malignant disease are increased, which are no siginificant different to patients with benign disease. Early diagnosis and an aggressive surgical approach are crucial to achieve better outcomes for patients with GSC.

Objective To investigate the feasibility of laparoscopic D3 lymphadenectomy combined with pelvic autonomic nerve preservation for rectal cancer.Methods The clinical data of 34 patients with rectal cancer who had been admitted to OUr hospital from January 2007 to December 2007 were retrospectively analyzed.All patients underwent laparoscopic D3 lymphadenectomy combined with pelvic autonomic nerve preservation.The operation time,lymph node dissection,postoperative complications were assessed.The erectile function of male patients and the short-term outcome of the operation were evaluated.Results All patients were successfully operated on,and no conversion Was required.The mean operation time,blood loss,number of lymph node dissected,time of catheterization,mearl volume of residual urine and CEA were(265+46)minutes,(123±27)ml and 19±3,(5.5±1.6)days,(22.5±7.8)ml and(8.0±4.6)U/L,respectively.The incidence of postoperative complications and male sexual dysfunction were 9%(3/34)and 14%(3/21),respectively.No local recurrence or distal metastasis Was observed at the end of August 2008.Conclusions Laparoscopic D3 lymphadenectomy combined with pelvic autonomic nerve preservation for rectal cancer is relatively safe and feasible.

Objective To investigate the influence of laparoscopic D3 lymphadenectomy combined with pelvic autonomic nerve preservation on the urinary function of male patients with rectal cancer. Methods From August 2006 to August 2007, 119 male patients with rectal cancer who had been admitted to Southwest Hospital were assigned to open surgery group (n=59) and laparoscopic group (n=60) according to the random number table. Three months after the operation, the urinary function of patients was assessed by urodynamics investigation and international prostate symptom score (IPSS). Differences in measurement data were compared with paired t test. Results There was no significant difference in IPSS between laparoscopic group (10.9±2.9) and open surgery group (11.5±3.1) (t=-1. 309, P>0.05). The maximum flow rate, voided volume, residual urine volume, detrusor contraction pressure and maximum urethral pressure were 15.2 ml/s, 150.1 ml, 6.1 ml, 43.3 cm H2O (1 cm H2O=0.098 kPa) and 77.5 cm H2O in laparoscopic group, and 15.0 ml/s, 140.9 ml, 6.4 ml, 45.6 cm H2O and 72.3 cm H2O in open surgery group, with no statistical difference between the 2 groups (t=1.22, -2.12, -1.73, -1.35, -1.64, P>0.05). Conclusions Laparosceopic D3 lymphadenectomy combined with pelvic autonomic nerve preservation is relatively safe in preserving urinary function, and its efficacy is comparable to that of open surgery.

Objective To study the expression of VEGF-C and it's relationship with pathologic characteristics in rectal cancer.Method In this study 82 patients of mid to low rectal cancer underwent radieal resection from December 2007 to August 2008.Tumor tissues and lymph nodes were studied by immunohistochemical staining for VEGF-C expression in the tumor tissue and CK20 expression in D3 lymph nodes.Results were compared with the pathological results of mesenterium lymph nodes to explain the relationships between VEGF-C expressions and clinical pathologic characteristics.Data were analyzed with Chi square test.Result As for the expression of VEGF-C.significant differences were found between tumor stages(X~2=8.529,P<0.05)and between positive and negative lymph node metastasis(X~2=4.712,P<0.05).but there was no difference between that of mesenterium lymph node metastasis and D3 lymph node micrometastasis(X~2=0.017,P>0.05). Conclmion In rectal cancer,VEGF-C expression is correlated with tumor stage,type,metastasis and micrometastasis of lymph node.

Objectives To observe the effect of Luoyutong capsule on neurological function following focal cerebral ischemia-reperfusion in rats and to preliminarily study the protective mechanism of Luoyutong capsule for focal cerebral ischemia-reperfusion in rats. Methods A rat model of middle cerebral artery occlusion (MCAO)was induced by the modified Longa method. After 1. 5 h of ischemia,reperfusion started. Ten male SD rats were selected as sham operation group,and forty male SD rats were randomly divided into 4 groups:Model (MCAO),Luoyutong moderate-dose (LYTM),Luoyutong high-dose (LYTH),and citicoline sodium (CS)groups (n=10 in each group). At day 3 and 7 after modeling,the neurological function of the rats was evaluated by using 12 neurological score and forelimb placing test. Western blotting was used to detect the expression levels of brain derived neurotrophic factor (BDNF),basic fibroblast growth factor (b-FGF),and phosphor/protein kinase (p-AKT/AKT)on the ischemic side of the rats and in the ipsilateral brain tissue at day 3 after modeling,as well as the expression level of Caspase-12 at day 7 after modeling in the ipsilateral brain tissue,and a comparison was performed among the groups. Results (1 )Neurological score:At day 3 after modeling,there was no significant difference between the 12 neurological score and the forelimb placing test score (all P>0. 05);At day 7 after modeling, there were obvious improvement in the LYTM,LYTH,and CS groups compared with model group (all P<0.05). (2)The results of western blot showed that①compare with the sham operation group,the expression levels of BDNF and b-FGF were reduced obviously (all P<0.05);compare with the MCAO group,the expression levels of the LYTM,LYTH and CS groups could be up-regulated,particularly in the LYTH group (P<0. 01);② compare with the sham operation group,the expression level of p-AKT/AKT in MCAO group was decreased obviously (P<0. 05);compare with the MCAO group,the expression levels of p-AKT/AKT of the LYTM,LYTH,and CS groups were increased,particularly in the LYTH and CS groups (all P<0. 05);③ compared with the sham operation group,the expression of cleavage Caspase-12 was increased obviously in the MCAO group (P<0. 05). Compared with the MCAO group,the expression levels of proCaspase-12 and cleavage Caspase-12 had a decreasing trend in the LYTM and LYTH groups,but there were no significant differences (all P >0. 05);the expression levels of proCaspase-12 and cleavage Caspase-12 in the CS group were obviously lower than those of the MCAO group (P<0. 05). Conclusion Luoyutong capsule may play a protective effect for focal cerebral ischemia-reperfusion injury in rats by promoting neural survival and regeneration,and this protective effect may be associated with the inhibition of neuronal apoptosis.

Objectives To assess the effect of nicorandil and trimetazidine on myocardial microcirculation reperfusion in patients with NSTEMI after elective PCI. Methods 80 patients with NSTEMI were randomly assigned to four groups: normal medicine group (CON), nicorandil group (NIC), trimetazidine group (TMZ) and Combination group (NIC+TMZ). The coronary angiography and PCI were performed after 10 days. MCE was taken since 72 hours after operation. Results There were no significant differences in baseline characteristics between the four groups (P > 0.05). The A, β and A ·β of group NIC were significantly higher than group CON (P < 0.05). There were no significant differences between the group TMZ and the group CON (P>0.05). The A,βand A·βof group NIC+TMZ were significantly higher than group NIC or TMZ (P<0.05). Conclusions Nicorandil can improve the situation of myocardial reperfusion after elective PCI in patients with NSTEMI, and it has some synergetic effect when combined with trimetazidine.

AIM: To investigate the effects of granulocyte colony-stimulating factor (G-CSF)-mobilized bone marrow stem cells on treatment of the myocardial infarction in experimental rats. METHODS: Three hours after injected with isoprenaline(ISO) interaperitoneally to develop acute ischemic model, rats' bone marrow stem cells were mobilized by G-CSF and migrated to the site of myocardial infarction. The hearts were harvested from 24 hours to 2 weeks after administration of ISO for histopathological examination. RESULTS: 24 hours after administration of ISO , myocardial infarct zones scattered in the pallium of the control group ,there were a large amoumt of inflammatory cells infiltration around the infarct zones and majority of them were neutrophils. The infarction in the G-CSF treatment group was milder, majority of the infiltrative cells were monocytoid; 48 hours after administration of ISO, infarct zones expanded greatly in control group, while that of the G-CSF treatment group increased just mildly; 2 weeks after administration of ISO, there was no significant scar in the G-CSF treatment group. We also found the regeneration of myocytes in the pallium. CONCLUSION: G-CSF treatment protected the ischemic myocardium and it may be used to treat the acute myocardial infarction.